Frequency, determinants and outcome of elevated troponin in acute ischemic stroke patients
International Journal of Cardiology,

Scheitz JF et al. – Elevation of cardiac troponins (cTnT) occurs in every seventh patient with acute ischemic stroke and is independently associated with poor short–term outcome and mortality. Patients with strokes affecting the insular cortex are particularly prone to myocardial injury justifying intensive cardiac monitoring.

Methods
  • The authors performed a retrospective analysis including all consecutive ischemic stroke patients admitted to the stroke unit within 72h after symptom onset in a one-year period.
  • Multivariable logistic regression analyses were conducted to identify determinants of cTnT elevation and to detect factors independently associated with unfavorable short-term outcome (modified Rankin scale >2), major neurologic improvement (improvement of NIHSS>=8 or NIHSS 0–1) and in-hospital mortality.

Results
  • Admission cTnT levels were measured in 715 ischemic stroke patients.
  • Frequency of cTnT elevation was 14% (n=103).
  • Factors independently associated with increased cTnT were higher stroke severity (p=0.04), renal insufficiency (p<0.001), pre-existing coronary artery disease (p=0.03), hypercholesterolemia (p=0.02) and insular cortex involvement (p<0.001).
  • After exclusion of patients with renal insufficiency and coronary artery disease frequency of cTnT elevation was 10% (n=44) and only insular cortex involvement remained significantly associated.
  • Increased cTnT on admission was an independent predictor of unfavorable outcome (adjusted odds ratio 2.65 [95% confidence interval 1.29–5.46]) and in-hospital mortality (4.51 [1.93–10.57]).
  • There was a trend towards a negative association of cTnT elevation with major neurologic improvement (0.54 [0.27–1.07]).

Please login or register to follow this author.
► Click here to access PubMed, Publisher and related articles...
<< Previous Article | Next Article >>

Your Unread Messages in Emergency Medicine

See All >> Messages include industry-sponsored communications and special communications from MDLinx

Most Popular Emergency Medicine Articles

1 Chemicals found in everyday fruits could minimise organ damage after heart attack and stroke University of Cambridge News, November 14, 2014

2 Does a single dose of intravenous dexamethasone reduce Symptoms in Emergency department patients with low Back pain and RAdiculopathy (SEBRA)? A double-blind randomised controlled trial Emergency Medicine Journal, August 22, 2014    Clinical Article

3 The PICHFORK (Pain in Children Fentanyl or Ketamine) trial: A randomized controlled trial comparing intranasal ketamine and fentanyl for the relief of moderate to severe pain in children with limb injuries Annals of Emergency Medicine, November 20, 2014    Clinical Article

4 Comparison of therapeutic effects of magnesium sulfate vs. dexamethasone/metoclopramide on alleviating acute migraine headache The Journal of Emergency Medicine, October 10, 2014    Clinical Article

5 Incidence of emergency department visits for ST-elevation myocardial infarction in a recent 6-year period in the United States The American Journal of Cardiology, November 7, 2014    Clinical Article

6 Antiemetic use for nausea and vomiting in adult emergency department patients: randomized controlled trial comparing ondansetron, metoclopramide, and placebo Annals of Emergency Medicine, October 28, 2014    Clinical Article

7 Accuracy and radiation dose reduction of a limited abdominopelvic CT in the diagnosis of acute appendicitis Abdominal Imaging , October 24, 2014    Clinical Article

8 Sleeping in moderate hypoxia at home for prevention of acute mountain sickness (AMS): A placebo-controlled, randomized double-blind study Wilderness & Environmental Medicine, November 11, 2014    Clinical Article

9 Resuscitation science tip sheet American Heart Association News, November 18, 2014

10 The use of echocardiography in acute cardiovascular care: Recommendations of the European Association of Cardiovascular Imaging and the Acute Cardiovascular Care Association European Heart Journal: Acute Cardiovascular Care, November 17, 2014    Clinical Article

11 CDC Statement: (Update) New York City and CDC report positive tests for Ebola in volunteer international aid worker Full Text CDC, October 27, 2014    Free full text

12 Since the start of the Ebola outbreak, half of Liberian doctors have died Duke University Health & Medicine News, October 2, 2014

13 Use of cardiac biomarker testing in the emergency department JAMA Internal Medicine, November 21, 2014    Evidence Based Medicine    Clinical Article

14 Early versus delayed administration of norepinephrine in patients with septic shock Critical Care, October 8, 2014    Clinical Article

15 Paradox lost: Speedier heart attack treatment does save more lives after all, study suggests University of Michigan Health System, November 20, 2014

16 Temple study suggests a novel approach for treating non-cardiac chest pain Temple Health, October 22, 2014

17 Children's relentless seizures halted by new drug Northwestern Medicine News, November 25, 2014

18 Effects of unconsciousness during spinal immobilization on tissue-interface pressures: A randomized controlled trial comparing a standard rigid spineboard with a newly developed soft-layered long spineboard Injury, November 6, 2014    Clinical Article

19 Study: Splints placed improperly in 93% of suspected pediatric fractures treated in emergency rooms/urgent care centers University of Maryland Medical Center News, October 13, 2014

20 Early deterioration after thrombolysis plus aspirin in acute stroke Stroke, September 25, 2014    Clinical Article

Indexed Journals in Emergency Medicine: Journal of Emergency Medicine, Annals of Emergency Medicine, Injurymore