Does a positive troponin level predict death and myocardial ischemia in acute stroke patients?
Elevated troponin is found in nearly one-fifth of acute stroke patients and is a strong independent predictor of death and myocardial ischemia.
BACKGROUND: Troponin levels are elevated in some acute stroke patients, but the clinical significance of this is unclear. METHODS: We conducted a systematic review of studies measuring troponin within 7 days of symptom onset in acute stroke patients. RESULTS: We identified 15 studies (2,901 patients). Overall 18.1% (95% CI 13.6-22.6) had a positive troponin level. These patients were more likely to have electrocardiogram (ECG) changes suggestive of myocardial ischemia (OR 3.0; 95% CI 1.5-6.2), and there was an independent association with death (OR 2.9; 95% CI 1.7-4.8). CONCLUSION: Elevated troponin level after acute stroke is common and is associated with ECG changes suggestive of myocardial ischemia and increased risk of death.
Kerr et al. (2009) studied this question.
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