Frequency and Significance of Troponin T Elevation in Acute Ischemic Stroke

Jensen, Jesper K.; Kristensen, Søren Risom; S, Bak; Atar, Dan; Høilund‐Carlsen, Poul Flemming; Mickley, Hans

doi:10.1016/j.amjcard.2006.07.071

Cited by 147 publications

(104 citation statements)

References 22 publications

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“…16 Patients with overt ischemic heart disease (nϭ177; ie, any prior myocardial infarction, stable or unstable angina pectoris, pathological Q-waves on the baseline electrocardiogram, previous coronary angioplasty or coronary bypass surgery), patients with current atrial fibrillation (nϭ132), or patients with onset of stroke symptoms Ͼ7 days before admission (nϭ75) were not included. In addition, 115 patients were excluded because of technical reasons or lack of compliance and 47 patients were unwilling to participate, rendering 244 patients eligible for inclusion in the study.…”

Section: Methodsmentioning

confidence: 99%

Activated Leukocyte Cell Adhesion Molecule and Prognosis in Acute Ischemic Stroke

Smedbakken

Jensen

Hallén

et al. 2011

Stroke

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Background and Purpose-Biomarkers predicting mortality and functional outcome in stroke may be clinically helpful in identification of patients likely to benefit from intervention. Activated leukocyte cell adhesion molecule (ALCAM) is upregulated during neuroinflammation; we investigated whether ALCAM concentrations are associated with long-term mortality after ischemic stroke. Methods-In 244 patients with acute ischemic stroke (age 69Ϯ13 years), samples of ALCAM were obtained serially from presentation to Day 5 and after 6 months. Patients with overt ischemic heart disease and atrial fibrillation were excluded. The patients were followed for 47 months with all-cause and cardiovascular mortality as end points. Results-At follow-up, 72 patients (29%) had died, 43 due to cardiovascular causes. Patients with ALCAM in the fourth quartile (Ͼ46.8 ng/mL) at admission had a significantly poorer survival rate on univariate analysis (PϽ0.001); other time points did not add further but provided similar prognostic information. In multivariate analysis, after adjustment for age, stroke severity, C-reactive protein levels, troponin T levels, and heart and/or renal failure, ALCAM levels above the fourth quartile remained an independent predictor of long-term mortality (adjusted hazard ratio, 2.05; 95% CI, 1.11 to 3.76; Pϭ0.021) and cardiovascular mortality (adjusted hazard ratio, 2.54; 95% CI, 1.06 to 6.07; Pϭ0.028). Conclusions-ALCAM levels measured at admission of acute ischemic stroke are associated with long-term mortality. (Stroke.2011;42:2453-2458.)

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Section: Methodsmentioning

confidence: 99%

Activated Leukocyte Cell Adhesion Molecule and Prognosis in Acute Ischemic Stroke

Smedbakken

Jensen

Hallén

et al. 2011

Stroke

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“…Several studies have shown that the amount of cTnT elevation is associated with a poor prognosis among patients with cerebrovascular disease. 13,14) However, the present study excluded patients with prior cerebrovascular disease. Reports indicate that DM and LV hypertrophy, which might be associated with ongoing myocardial damage according to the present study, are risk factors for cerebrovascular disease.…”

Section: Pathophysiological Roles Of Ongoing Myocardial Damage For Dementioning

confidence: 99%

“…13,14) The present study evaluated the relationship between elevated cTnT and the development of cardiovascular and cerebrovascular diseases in hypertensive patients without left ventricular (LV) systolic dysfunction.…”

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confidence: 99%

Elevated Cardiac Troponin T Predicts Adverse Outcomes in Hypertensive Patients

et al. 2011

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SummaryOngoing myocardial damage detected as elevated serum cardiac troponin T (cTnT) indicates increased risk for future cardiac events in patients with chronic heart failure. Whether elevated cTnT is associated with adverse outcomes in patients with hypertension (HT) without left ventricular (LV) systolic dysfunction is unknown.We measured cTnT levels in 176 patients with essential HT without LV systolic dysfunction (LV ejection fraction ≤ 55%), renal failure, and prior cardiovascular or cerebrovascular diseases and 39 normal controls. Levels of cTnT were elevated ( ≥ 0.02 ng/mL) in 15 (9%) of the 176 patients and in 0 (0%) of the 39 normal controls (P = 0.04). The rate of diabetes mellitus (DM), the cardiothoracic ratio, plasma B-type natriuretic peptide (BNP) value, and LV mass index were significantly higher in patients with than without elevated cTnT (DM, 8/15 versus 29/161, P = 0.004; cardiothoracic ratio, 54.5 ± 4.5 versus 51.6 ± 5.2%, P = 0.04; BNP, 103.3 ± 142.3 versus 36.9 ± 50.7 pg/mL, P = 0.04; LV mass index, 227 ± 87 versus 152 ± 57 g/m 2 , P = 0.0001). Kaplan-Meier analysis demonstrated that significantly fewer (P < 0.000001) patients with, than without elevated cTnT remained free of events (hospitalization due to cardiovascular or cerebrovascular disease, n = 34). Stepwise Cox multivariate analysis revealed that elevated cTnT (hazard ratio, 6.58; P = 0.000001) and smoking (hazard ratio, 2.24; P = 0.04) were independent predictors of events.The present findings indicate that cTnT is a novel and useful predictor of future cardiovascular or cerebrovascular events in hypertensive patients. (Int Heart J 2011; 52: 164-169)

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“…Furthermore, patient with elevated cTnT had a higher frequency of heart and/ or renal failure as well as increased risk of mortality within the following two years [16].…”

Section: Discussionmentioning

confidence: 99%

Cardiac electrical and biochemical abnormalities in acute stroke: A case report

Bakhsh¹,

Alkhawam²,

Zaiem³

et al. 2015

IJCRI

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International Journal of Case Reports and Images (IJCRI) is an international, peer reviewed, monthly, open access, online journal, publishing high-quality, articles in all areas of basic medical sciences and clinical specialties.Aim of IJCRI is to encourage the publication of new information by providing a platform for reporting of unique, unusual and rare cases which enhance understanding of disease process, its diagnosis, management and clinico-pathologic correlations. We report a case of 87-year-old female presented with cough, lethargy, decreased oral intake, shortness of breath, chest pain and altered mental status. Head computed tomography (CT) scan did not reveal any acute intracranial pathology. Laboratory work showed cardiac troponin T elevation with ECG changes were concerning for cardiac ischemia. Careful examination was significant for right facial droop and right sided weakness. A repeat head CT scan showed acute stroke. IJCRI publishes Conclusion:Patient with ischemic stroke may have shown to have an association with elevated cTnT. They are at an increased risk of mortality from renal and/or cardiac failure. Though ECG changes and cTnT levels can be attributed to stroke, given the common risk factors shared by coronary artery disease and stroke, a cardiac work up is warranted to rule out any acute myocardial event or look up for the source of stroke which most likely to be cardiac.

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Frequency and Significance of Troponin T Elevation in Acute Ischemic Stroke

Cited by 147 publications

References 22 publications

Activated Leukocyte Cell Adhesion Molecule and Prognosis in Acute Ischemic Stroke

Activated Leukocyte Cell Adhesion Molecule and Prognosis in Acute Ischemic Stroke

Elevated Cardiac Troponin T Predicts Adverse Outcomes in Hypertensive Patients

Cardiac electrical and biochemical abnormalities in acute stroke: A case report

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