Troponin Elevations after Cardiac Surgery: Just “Troponitis”?

Beek, Dianne E C van; Horst, Iwan C. C. van der; Scheeren, Thomas

doi:10.1007/978-3-030-37323-8_9

Cited by 1 publication

(1 citation statement)

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“…Clinical decision-making regarding troponin elevations in stroke patients is a multifaceted challenge that requires careful consideration of various factors. While elevated troponin levels in stroke patients can indicate myocardial injury, termed “troponitis,” it’s essential to recognize that other contributing factors such as stress, sepsis, or renal dysfunction may also lead to troponin elevation, particularly in the acute phase of a stroke ( 86 ). Therefore, clinicians must conduct a thorough evaluation to differentiate between myocardial infarction and other causes of troponin elevation ( 87 ).…”

Section: Discussionmentioning

confidence: 99%

Elevated troponin levels as a predictor of mortality in patients with acute stroke: a systematic review and meta-analysis

Gulia,

Srivastava,

Kumar

2024

Front. Neurol.

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Background and AimThe prognostic potential of cardiac troponin (cTn) in acute stroke patients has been a subject of ongoing debate. Our objective was to provide a comprehensive evidence for predicting mortality in acute stroke patients by using the elevated troponin levels.MethodsWe conducted an extensive literature search, including PubMed, EMbase, and Trip Databases, covering studies published up to September 30, 2023. We computed risk ratios (RR) with 95% confidence intervals (CIs), performed sensitivity analysis, and conducted trial sequential analysis (TSA).ResultsIn total, 53 studies were analyzed, with 37 focusing on acute ischemic stroke (AIS), 11 on subarachnoid hemorrhage (SAH), and 7 on Intracerebral hemorrhage (ICH). Elevated cTn levels were significantly showed a higher predictive risk for In-hospital mortality in both AIS (RR=3.80, 95% CI; 2.82 to 5.12) as well as SAH (RR=2.23, 95% CI; 1.64 to 3.02). However, no significant predictive risk between elevated cTn levels and in-hospital mortality for ICH patients (RR=1.13, 95% CI: 0.46 to 2.79). A similar pattern was observed for elevated cTn levels, indicating an increased risk of last follow-up mortality for AIS (RR=2.41, 95% CI: 1.98 to 2.93) and SAH (RR=3.08, 95% CI: 2.25 to 4.21).ConclusionElevated troponin levels can serve as a promising predictive marker for both in-hospital and last follow-up mortality in AIS and SAH patients but not in ICH patients. Further prospective studies are needed to validate our findings along with exploring the preventive management of mortality in acute stroke settings.

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Section: Discussionmentioning

confidence: 99%