Troponin T: Correlation with location and volume of acute brain infarction

Král, Michal; Šaňák, Daniel; Veverka, Tomáš; Hutyra, Martin; Vindiš, David; Bártková, Andrea; Kunčarová, Anna; Dorňák, Tomáš; Čecháková, Eva; Herzig, Roman; Langová, Kateřina; Kaňovský, Petr; Školoudík, David

doi:10.1016/j.ijcard.2014.12.027

Cited by 9 publications

(8 citation statements)

References 39 publications

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“…Nevertheless, whether baseline hsTnT elevation is associated with any infarct location remains uncertain, because study results are conflicting: three studies described involvement of the right insular cortex and right inferior parietal lobe to be associated with baseline hsTnT elevation,[10–12] but other studies did not. [13,14] In our detailed voxel based analysis we did not find any association of infarct location with baseline hsTnT. Interestingly, a recent study found an association of infarct location with temporal changes of hsTnT but not with baseline hsTnT.…”

Section: Discussioncontrasting

confidence: 58%

“…In accordance with previous studies, we identified renal failure to be associated with hsTnT elevation. [13,22] In addition, ST segment depression and negative T waves on baseline ECG were associated with hsTnT elevation. As both MI and NSM can be accompanied by ST segment depression and negative T waves, these ECG findings do not help to differentiate between the two etiologies.…”

Section: Discussionmentioning

confidence: 99%

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Baseline Troponin T level in stroke and its association with stress cardiomyopathy

et al. 2018

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BackgroundDifferential diagnosis of elevated high sensitive Troponin T (hsTnT) in acute ischemic stroke includes myocardial infarction (MI) and neurogenic stunned myocardium (NSM). The aim of this study was to identify factors associated with baseline hsTnT levels and MI or NSM in acute ischemic stroke.MethodsWe studied 204 consecutive patients of the prospective acquired Bern Stroke Database with acute ischemic stroke diagnosed by brain MR. All patient histories and cardiac examinations were reviewed retrospectively. Volumetry of lesions on diffusion and perfusion weighted brain imaging (circular singular value decomposition, Tmax >6sec) was performed. Voxel based analysis was performed to identify brain areas associated with hsTnT elevation. Linear regression analysis was used to identify predictors of baseline hsTnT levels and myocardial infarction.ResultsElevated hsTnT was observed in 58 of the 204 patients (28.4%). The mean age was 68.3 years in the normal hsTnT group and 69.7 years in the elevated hsTnT group. Creatinine (p<0.001, OR 6.735, 95% CI 58.734–107.423), baseline NIHSS score (p = 0.029, OR 2.207, 95% CI 0.675–12.096), ST segment depression (p = 0.025, OR 2.259, 95% CI 2.419–35.838), and negative T waves in baseline ECG (p = 0.002, OR 3.209, 95% CI 13.007–54.564) were associated with hsTnT elevation, while infarct location and size were not. Coronary angiography was performed in 30 of the 204 patients (14.7%) and myocardial infarction was diagnosed in 7 of them (23.3%). Predictive factors for myocardial infarction could not be identified.ConclusionElevated baseline baseline hsTnT was associated with NIHSS, creatinine, ST segment depression and inverted T waves, but not with stroke location or size. None of the factors was helpful to differentiate MI and NSM. Therefore, ancillary investigations such as coronary angiography, cardiac MRI or both may be needed to solve the differential diagnosis.

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Section: Discussioncontrasting

confidence: 58%

Section: Discussionmentioning

confidence: 99%

Baseline Troponin T level in stroke and its association with stress cardiomyopathy

et al. 2018

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“…Although there was a significant relationship between increased infarct volume and increased troponin volume in some studies comparing troponin increase with infarct volume in acute stroke patients, this relationship could not be found in a study in which more patient groups were included. Therefore, there is no clarity on this subject according to current studies (6). In our study, when troponin values were compared between anterior system tandem occlusions and isolated MCA occlusions, no significant difference was found between the two groups.…”

Section: Discussioncontrasting

confidence: 59%

“…Characteristically, chest pain, epigastric pain, pain spreading to the arm are complaints in patients with acute myocardial infarction, while some patients have atypical symptoms and even silent ischemia cases can be seen. From this perspective, troponin elevation or similarity of complaints can be seen also in stroke patients (6).…”

Section: Discussionmentioning

confidence: 98%

Comparison of troponin levels in isolated middle cerebral artery and anterior system tandem occlusion treated with mechanical thrombectomy

Şengeze¹,

Gıray²,

İnanç³

et al. 2019

TÃ¼rk Beyin Damar Hast Derg

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INTRODUCTION: Ischemic stroke is the most common disability worldwide and the second most common cause of mortality. One of the major causes of mortality in patients with ischemic stroke is cardiac complications. However, high levels of troponin may be caused in patients with ischemic stroke and many of the systemic diseases that has a risk for the stroke. In this study, we aimed to investigate troponin levels of stroke patients who were treated with mechanical thrombectomy and the resulting risk factors for stroke, mortality and physical dependence at the end of the third month in tandem and M1 occlusions. METHODS: In this study, troponin values are examined retrospectively in stroke patients with tandem occlusion of the anterior circulation and middle cerebral artery M1 occlusions, who were treated between January 2015 and February 2019. SPSS Windows 23 package program was used in the statistical analysis of the data obtained from the study. Troponin values in tandem and middle cerebral artery occlusion were compared with chi-square method. Results were evaluated at 95% confidence interval and p<0.05 level of significance. RESULTS: When the mortality rates between tandem and MCA occlusions were examined at the end of the third month, mortality rates were higher in tandem occlusions and there was a statistically significant difference between the two groups (p: 0.027). There was no significant difference between tandem and MCA occlusions in terms of troponin values (p: 0.63). Patients with troponin values above 0.028 ng / mL had significantly higher mortality at 3 months. DISCUSSION and CONCLUSION: There is a relationship between mortality and elevation of troponin levels in patients who had tandem and MCA occlusions. However, there was no difference between tandem and MCA occlusions in terms of troponin values significantly. There is a need to further study the impact of ischemic stroke on troponin levels with randomized, controlled studies. MEKANİK TROMBEKTOMİ İLE TEDAVİ EDİLEN İZOLE ORTA SEREBRAL ARTER VE ÖN SİSTEM TANDEM OKLÜZYONU OLGULARINDAKİ TROPONİN DÜZEYLERİNİN KARŞILAŞTIRILMASIÖZET GİRİŞ ve AMAÇ: İskemik inme tüm dünyada en sık sakatlık bırakan ve ikinci sıklıkta mortaliteye neden olan hastalıktır. İskemik inme geçiren hastalarda mortalitenin önemli nedenlerinden biri de kardiyak komplikasyonlardır. Troponin, akut miyokard infarktüsünün tanısında ve akut koroner semptomları olan hastaların risk sıralamasında kullanılan yüksek duyarlılığı ve özgünlüğü olan bir belirteçtir. Bununla birlikte, iskemik inmeli hastalarda troponin yüksekliğine inme için ri sk oluşturan sistemik hastalıkların birçoğu neden olabilmektedir. Biz çalışmamızda mekanik trombektomi ile tedavi ettiğimiz tandem oklüzyonlar ve orta serebral arter M1 oklüzyonlarındaki troponin seviyelerini, inme risk faktörlerini, üçüncü ay sonundaki mortalite ve fiziksel bağımlılığı incelemeyi amaçladık. YÖNTEM ve GEREÇLER: Çalışmada Ocak 2015-Şubat 2019 yılları arasından hastanemize başvuran ve mekanik trombektomi ile tedavi edilen ön sistem tandem okl...

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“…The insula is important for the central autonomic regulation and is frequently affected in anterior circulation stroke, and an association between right insula cortex stroke and increased cardiac troponin has been shown (44 ). However, others have not found a relation between increased cardiac troponin and the location or volume of brain infarction (45 ). In addition, a massive catecholamine exposure may also lead to ischemic myocardial injury via coronary vasoconstriction or tachyarrhythmia especially in those with preexisting coronary artery disease (type 2 MI).…”

Section: Strokementioning

confidence: 99%

Application of Cardiac Troponin in Cardiovascular Diseases Other Than Acute Coronary Syndrome

Eggers¹,

Lindahl

2017

Clinical Chemistry

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BACKGROUND Increased cardiac troponin concentrations in acute coronary syndrome (ACS) identify patients with ongoing cardiomyocyte necrosis who are at increased risk. However, with the use of more precise assays, cardiac troponin increases are commonly noted in other cardiovascular conditions as well. This has generated interest in the use of cardiac troponin for prognostic assessment and clinical management of these patients. In this review, we have summarized the data from studies investigating the implications of cardiac troponin concentrations in various acute and chronic conditions beyond ACS, i.e., heart failure, myocarditis, Takotsubo cardiomyopathy, aortic dissection, supraventricular arrhythmias, valve disease, pulmonary arterial hypertension, stroke, and in the perioperative setting. CONTENT Cardiac troponin concentrations are often detectable and frankly increased in non-ACS conditions, in particular when measured with high-sensitivity (hs) assays. With the exception of myocarditis and Takotsubo cardiomyopathy, cardiac troponin concentrations carry strong prognostic information, mainly with respect to mortality, or incipient and/or worsening heart failure. Studies investigating the prognostic benefit associated with cardiac troponin–guided treatments however, are almost lacking and the potential role of cardiac troponin in the management of non-ACS conditions is not defined. SUMMARY Increased cardiac troponin indicates increased risk for adverse outcome in patients with various cardiovascular conditions beyond ACS. Routine measurement of cardiac troponin concentrations can however, not be generally recommended unless there is a suspicion of ACS. Nonetheless, any finding of an increased cardiac troponin concentration in a patient without ACS should at least prompt the search for possible underlying conditions and these should be managed meticulously according to current guidelines to improve outcome.

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Troponin T: Correlation with location and volume of acute brain infarction

Cited by 9 publications

References 39 publications

Baseline Troponin T level in stroke and its association with stress cardiomyopathy

Baseline Troponin T level in stroke and its association with stress cardiomyopathy

Comparison of troponin levels in isolated middle cerebral artery and anterior system tandem occlusion treated with mechanical thrombectomy

Application of Cardiac Troponin in Cardiovascular Diseases Other Than Acute Coronary Syndrome

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