Key result
Elevated serum cardiac troponin-T (>0.035 ng/ml) in patients with acute ischemic stroke was significantly associated with abnormal ECG findings, greater stroke severity, and higher in-hospital mortality, whereas elevated CK-MB was not.
Why the study?
Data were conflicting regarding the role of cardiac troponin and creatine kinase in stroke patients, and the study aimed to evaluate the prognostic implications of CT-T and CK-MB in acute ischemic stroke.
Do elevated cardiac troponin T and CK-MB levels predict stroke severity and in-hospital mortality in patients with acute ischemic stroke?
Cross-Sectional (n=70)
No
Do elevated cardiac troponin T and CK-MB levels predict stroke severity and in-hospital mortality in patients with acute ischemic stroke?
Absolute Event Rate: 25% vs 3.7%
p-value: p=0.05
Elevated cardiac troponin T levels in acute ischemic stroke patients may indicate asymptomatic myocardial injury and are associated with stroke severity and in-hospital mortality.
Elevated cardiac troponin in ischemic stroke is associated with higher mortality; leaves open whether measurement should guide cardiac workup or reflects reversible neurocardiogenic injury.
Background: Quite a lot of articles have been printed confirming the central nervous system's role in regulating the heart and hence ECG morphology. There are conflicting outcomes on the likely role of cardiac troponin (CT) and creatine kinase (CK) in stroke patients. Raised cardiac enzymes during stroke probably as a thrombo-embolic sequel of the initial cardiac injury or the cardiac injury could be a sequel to the initial stroke. This study was intended to evaluate the prognostic implication of CT-T and CK-MB in patients with acute ischemic stroke (AIS). Material and methods: This single-center cross-sectional study included seventy inpatients admitted with acute ischemic stroke (AIS). History, 12leads-ECG, and blood sampling for CT-T and CK-MB levels were performed for all candidates. Then, these variables were analyzed based on the stroke severity that was assessed using Scandinavian Stroke Scale (SSS) and on the in-hospital short-term fate (death or survival) registered. SPSS was the referenced software for the statistical analysis. Results: the mean age of AIS patients was 60 years (range of 35-85) with a preponderance of males 46 (65.7%). Minority of patients revealed CT-T levels > 0.035ng/ml (22.9%) and CK-MB> 25IU/L (35.7%). Abnormal ECG findings were observed in < 50% of the patients and in m<2/3 rd of them the SSS were > 20, with a survival rate of (81.4%). There was more serum CT-T elevation among the patient group with abnormal ECG, more stroke severity, and in-hospital death (p>0.05). While there was a non-significant association (p>0.05) of elevated CK-MB levels with ECG abnormalities, stroke severity, and in-hospital death. Conclusion: There were higher CT-T serum levels among AIS patients, which can result from skeletal muscles, neurological, or cardiac origins. Raised CT-T levels were associated with stroke severity and in-hospital mortality and in combination with (ischemic-like) ECG changes in DM or hypertensive patients may point toward asymptomatic myocardial injury that warrants attention among those with positive CT-T measures. Meanwhile, the raised CK-MB level was not associated with abnormalities, stroke severity, in-hospital mortality, and possibly of non-cardiac origin.
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A 2022 study conducted a cross-sectional in Acute Ischemic Stroke (n=70). Elevated Cardiac Troponin T (CT-T > 0.035 ng/ml) vs. Normal CT-T (≤ 0.035 ng/ml) was evaluated on In-hospital mortality (p=0.05). Elevated serum cardiac troponin-T (>0.035 ng/ml) in patients with acute ischemic stroke was significantly associated with abnormal ECG findings, greater stroke severity, and higher in-hospital mortality, whereas elevated CK-MB was not.
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