Why the study?
What is the clinical significance and proper interpretation of elevated troponin levels in patients with acute ischemic stroke?
What is the clinical significance and proper interpretation of elevated troponin levels in patients with acute ischemic stroke?
This review addresses the diagnostic dilemma of distinguishing between neurologically induced myocardial injury and myocardial infarction in patients with acute ischemic stroke and elevated troponin levels.
Troponin elevation in acute ischemic stroke warrants cautious interpretation; leaves open validated algorithms to distinguish injury from infarction.
Ischemic heart disease and cerebrovascular diseases may coexist in the same patient, and similar risk factors are shared. However, for several years, experimental and observational data have incessantly indicated that neurologically induced myocardial injury exists. This leaves the clinician with a diagnostic dilemma of how to distinguish between neurologically induced myocardial injury and myocardial infarction prior to the stroke. Since various alterations of the ECG have also been reported in this patient category, it has been suggested that elevated troponin levels are somehow neurologically mediated, thus not resulting from direct cardiac release. This review focuses on the available studies that systematically measured troponin in patients with acute ischemic stroke in order to properly interpret troponin elevations in these patients.
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Jesper K. Jensen (2008) studied this question.
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