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Summary
Elevated cardiac enzymes, particularly CK-MB (heart) iso-enzyme, are common in stroke patients, indicating acute myocardial involvement. This cardiac dysfunction appears to be a consequence, not a cause, of the cerebrovascular event.
Area of Science:
- Neurology
- Cardiology
- Biochemistry
Background:
- Stroke patients admitted to intensive care units often present with elevated cardiac enzyme levels.
- The relationship between acute cerebrovascular events and myocardial involvement requires further investigation.
Purpose of the Study:
- To investigate the incidence and significance of elevated serum cardiac enzyme levels in patients following acute stroke.
- To determine the tissue source of elevated creatine kinase (CK) using isoenzyme fractionation.
Main Methods:
- Serum cardiac enzymes (CK, LDH, SGOT) and ECG were monitored in stroke patients and controls.
- Creatine kinase (CK) isoenzymes (CK-MB, CK-MM, CK-BB) were analyzed in a subset of stroke patients.
Main Results:
- 8% of stroke patients showed elevated mean serum cardiac enzyme levels; TIA patients did not differ from controls.
- 11% of stroke patients had elevated CK-MB (heart) iso-enzyme, associated with increased evidence of myocardial ischemia and arrhythmias.
- No significant elevation of CK-BB (brain) iso-enzyme was detected in any patient.
Conclusions:
- Acute myocardial involvement is a common complication in the early stages of stroke, potentially more so than previously recognized.
- Elevated CK-MB levels in stroke patients suggest myocardial dysfunction as a consequence, rather than a cause, of the cerebrovascular lesion.