The prognostic significance of troponin I elevation in acute ischemic stroke

Prevalence of Positive Troponin and Echocardiogram Findings and Association With Mortality in Acute Ischemic Stroke

“…Other European single center studies have not replicated this association when concurrent AMI, an important driver of mortality, was excluded. 29 In our population however non-AMI hypertroponinemia appears to carry more prognostic weight then a 5-point increase in the NIHSS, 10-year age increase, or current smoking (figure 1). …”

Relative Lack of Culprit and Obstructive Coronary Lesions in Patients With Acute Ischemic Stroke and Elevated Cardiac Troponin

“…8 These factors may play a role in stress-induced cardiomyopathy, which in its extreme form presents as Takotsubo cardiomyopathy. 15,16 This view is partially supported by a recent study, 12 which demonstrated that of the patients with acute ischemic stroke and positive cardiac troponins diagnosed as “supply-demand mismatch” based on best clinical practice, including ECG, echocardiography, stress test, or coronary angiography, 45% of patients had a rise-and-fall pattern in cardiac troponin and 8% had new wall motion abnormalities on echocardiography. However, a mechanistic pathophysiologic explanation of how neurologically mediated stress leads to the release of troponins is not clear, and further studies are needed to identify the potential sources of elevated cTn in patients who have had an acute ischemic stroke with no obvious culprit lesions or obstructive coronary artery disease.…”

“…6,7 Furthermore, ≈15% of patients with acute ischemic stroke have elevated cTn, 8–11 many of whom have no other clinical manifestation of acute coronary ischemia. Because cTn still provides important prognostic information regarding mortality outcomes in patients who have had a stroke, 12 current American Heart Association guidelines recommend its measurement in all patients presenting with acute ischemic stroke. 13 However, the role of cTn in predicting culprit or obstructive coronary lesions in these patients remains unknown, but may be important to ascertain if subsequent revascularization therapy could be shown to be beneficial.…”

Diagnostic and Prognostic Significance of Neutrophil Gelatinase- Associated Lipocalin and Pentraxin-3 in Acute Coronary Syndrome

“…Cardiac troponin is a highly sensitive and specific biomarker that demonstrates myocardial damage. However, it is not specific as high levels of it can also be detected in many clinical conditions (renal failure, gastrointestinal bleeding, respiratory disease, subarachnoid hemorrhage and ischemic stroke) other than ACS (4)(5)(6)(7)(8). In spite of this, cardiac troponins have recently been accepted as the gold standard biomarker in ischemic myocardial damage (9).…”