Application and Interpretation of High-Sensitivity Cardiac Troponin Assays in Patients With Acute Ischemic Stroke

Scheitz, Jan F.; Nolte, Christian H.; Laufs, Ulrich; Endres, Matthias

doi:10.1161/strokeaha.114.007858

Cited by 94 publications

(88 citation statements)

References 62 publications

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“…Furthermore, elevated troponin levels are associated with an almost 2-fold increased risk of 5-year mortality [16]. In concordance with our study several studies showed that the short-term and long-term unfavorable outcome has been associated with increased troponin levels [6,11,12,[15][16][17].…”

Section: Discussionsupporting

confidence: 91%

Impact of troponin I on outcome of ischemic stroke patients

Budinčević

Sremec²,

Črnac³

et al. 2017

Romanian Journal of Internal Medicine

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Introduction. Stroke is one of the leading causes of morbidity and mortality. Cardiac troponins have been found to be increased in other conditions apart from the cardiac diseases, such as stroke. The aim of the study was to assess the correlation between elevated troponin I levels and stroke outcome.Methods. This retrospective study included 198 acute ischemic stroke patients in whom troponin I levels have been obtained at admission. Exclusion criteria were concomitant acute coronary syndrome, congestive heart failure, pulmonary embolism, renal failure, rhabdomyolysis and septic conditions.Results. There was a statistically significant difference in the proportion of deaths during hospitalization (p = 0.041) and modified Rankin Scale scores (p = 0.016) between the group of patients with elevated troponin I levels and the control group. Prior ischemic strokes were more common in the group with elevated troponin I levels (p = 0.032). No other differences were observed.Conclusions. Our study showed that patients with elevated initial troponin I levels are associated with unfavorable outcome or death. Stroke may be associated with mild elevation of troponin levels, contrary to higher levels which are usually related to other conditions.

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Section: Discussionsupporting

confidence: 91%

Impact of troponin I on outcome of ischemic stroke patients

Budinčević

Sremec²,

Črnac³

et al. 2017

Romanian Journal of Internal Medicine

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“…Consistent with this is the recent finding that emboli extracted from the brains of individuals with ESUS during acute stroke treatment show features consistent with cardiogenic emboli 7. AF is associated with elevated troponin and subclinical AF has been suggested as the cause underlying cryptogenic stroke 8, 9. The elimination of patients later found to have AF from the analysis cohort did not substantially change the strength of the association, and long‐term monitoring of cardiac rhythm has demonstrated that a minority of ESUS patients have AF on follow‐up.…”

supporting

confidence: 57%

Embolic Stroke of Uncertain Source: An Entity Slowly Coming Into Focus

Sharma

2017

JAHA

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“…4 Although the vast majority of AIS patients do not clinically present with cardiac symptoms, ≈15% show cTn levels above the diagnostic threshold to suspect ongoing myocardial injury when conventional assays are used and up to 60% when high-sensitivity assays are applied. 5,6 Similar to findings in the general population and in patients with stable and acute cardiac disease, [7][8][9] cTn levels provide prognostic information on short-and long-term outcome after AIS.…”

mentioning

confidence: 71%

“…19,20 The so-called neurogenic heart syndrome can promote coronary demand ischemia or provoke diffuse myocyte necrosis (contraction band necrosis). 5,19 One variation of neurogenic heart syndrome is Takotsubo cardiomyopathy. 21 We did not find a difference in the frequency of Takotsubo cardiomyopathy among AIS and NSTE-ACS patients, but our study was not powered to detect a significant difference.…”

Section: Discussionmentioning

confidence: 99%

“…Besides acute coronary artery disease (CAD), strokeinduced myocardial injury, coronary supply-demand imbalance, and other noncoronary causes have been suggested as potential sources of cTn elevation in AIS patients. 5 Therefore, the aim of the Troponin Elevation in Acute Ischemic Stroke (TRELAS) study was to elucidate the possible coronary cause of cTn elevation in AIS by assessing the frequency of coronary culprit lesions on coronary angiogram. Age-and sex-matched patients presenting with NSTE-ACS served as control subjects.…”

mentioning

confidence: 99%

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