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Elevated Troponin Level with Negative Outcome Was Found in Ischemic Stroke

DOI: 10.1155/2013/953672

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Abstract:

Background. Troponin increment is a highly sensitive and specific marker of myocardial necrosis. The reason of high troponin levels in acute stroke is not clear. The aim of this study was to identify the relationships between cardiac troponin-I (cTnI) level and stroke. Methods. This study recruited 868 patients who were admitted to Istanbul Medeniyet University due to acute ischemic stroke, and the diagnosis was confirmed by diffusion magnetic resonance imaging. The patients with the causes increasing troponin level were excluded from the study. A total of 239 patients were finally included in the study. Clinics were evaluated by the modified Rankin Scale (mRS) and the National Institutes of Health Stroke Scale (NIHSS). Results. Serum level of troponin was higher in ischemic stroke patients with anterior circulation involvement in comparison to posterior involvement or hemorrhagic stroke ( ). Higher troponin levels related to increased stroke scale scores at discharge in ischemic stroke ( ). The level of cTnI was correlated with stroke scale scores at both admission and discharge in posterior stroke patients ( ). Conclusion. cTnI is a highly specific and sensitive marker of myocardial damage, and its elevation was associated with more severe neurological deficits in acute ischemic stroke. 1. Introduction Stroke is a leading cause of morbidity and also the third most common cause of death in the developed countries after cancer and ischemic heart disease [1]. The relationship between heart disease and acute stroke was shown previously [2]. It was well known that cardiac enzyme elevation and arrhythmias occurred in some ischemic stroke patients [3–7]. Serum levels of creatinine kinase myocardial fraction (CK-MB), lactate dehydrogenase (LDH), and cardiac troponin T are elevated in myocardial damage [8]. CK-MB levels are elevated not only in myocardial damage, but also in noncardiac conditions [8]. Troponin is a highly sensitive and specific marker of myocardial necrosis in comparison to CK-MB, and it is widely used in the diagnosis of acute myocardial infarction [9–11]. Troponin, a complex of three contractile regulatory proteins, that is, troponin C, T, and I, controls the calcium-mediated interactions between actin and myosin in cardiac and skeletal muscles [12]. Troponin-C is associated with both cardiac and skeletal muscles, but troponin-I and troponin-T are specific to cardiac muscles. Therefore, troponin-C is not used in the diagnosis of myocardial injury [12]. Cardiac troponin-T (cTnT) and cardiac troponin-I (cTnI) are released in cardiomyocytes;

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