Elevated troponin T (>0.04 microg/L), present in 9.6% of patients with acute ischaemic stroke, was significantly associated with a poor short-term outcome.
Cohort (n=279)
Do electrocardiographic changes and elevated troponin T predict poor short-term outcomes in patients with acute ischaemic stroke?
In patients with acute ischaemic stroke, ischaemic-like ECG changes (ST depression and Q waves) correlate with elevated troponin T, which is a significant predictor of poor short-term clinical outcomes.
BACKGROUND: The mechanisms explaining morphological electrocardiogram (ECG) changes and increased troponin T (TnT) in acute stroke are unclear. The aims of the present study were to assess the prevalence of ECG and TnT changes in acute ischaemic stroke, to investigate whether ischaemic-like ECG changes correlate to a rise in TnT and to examine whether ECG changes and elevated TnT predict a poor short-time outcome. METHODS: From 2000 to 2002 a total of 279 patients suffering from acute ischaemic stroke were included prospectively in the present study. ECG was carried out at admission and on day 1 in all patients. TnT was analysed at admission and on day 1. RESULTS: The most frequent ECG changes were: prolonged QTc 36.0%, ST depression 24.5%, atrial fibrillation 19.9% and T wave inversion 17.8%. In logistic regression analyses, ST depression and Q waves were significantly associated with a rise in TnT. TnT was elevated (>0.04 microg L(-1)) in 26 patients (9.6%). In logistic regression analyses, a rise in TnT was significantly associated with a poor short-term outcome (modified Rankin scale >3). CONCLUSION: ECG changes are prevalent in acute ischaemic stroke. ST depression and Q waves are related to an increase in TnT, suggesting that these ECG changes may indicate coexisting ischaemic heart disease. A rise in TnT predicts a poor outcome. Patients with acute ischaemic stroke should be offered adequate treatment with secondary prevention and preferably a follow-up with focus on cardiologic as well as neurological aspects.
Fure et al. (Fri,) conducted a cohort in acute ischaemic stroke (n=279). Elevated troponin T and ECG changes was evaluated on Poor short-term outcome (modified Rankin scale >3). Elevated troponin T (>0.04 microg/L), present in 9.6% of patients with acute ischaemic stroke, was significantly associated with a poor short-term outcome.