Journal of Kerman University of Medical Sciences

Troponin Serum Level in Ischemic Stroke Patients and its Prognostic Value

Document Type : Original Article

Authors

Farhad Iranmanesh 1
Akbar Hamzei-Moghadam 2
Mahbobeh Dehghan 3

1 Professor of Neurology, Stroke fellowship, Neurology Research Center, Kerman University of Medical Sciences, Kerman, Iran

2 Professor of Neurology, Neurology Research Center, Kerman University of Medical Sciences, Kerman, Iran

3 Neurologist, Neurology Research Center, Kerman University of Medical Sciences, Kerman, Iran

https://doi.org/10.22062/jkmu.2019.89576
Abstract
Background: Some recent studies have shown that troponin may have a Prognostic value in patients with ischemic stroke. This study seeks to to evaluate the prognostic value of troponin on 3 months mortality and recurrence in patients with ischemic stroke.
Method: In this study 63 patients with ischemic stroke were evaluated. Embolic and lacunar stroke were excluded from the study. In the first 24 hours, serum troponin levels were measured. Patients were evaluated for a three-month period in terms of death and recurrence of stroke, and the results were analyzed using independent t-test and logestic regression.
Results: In this study, 32 (50.8%) were male and the rest were female. Of the 63 patients studied, 8 (12.7%) had an abnormal troponin level. The mean serum level of troponin in patients who had died was 75.52 and patients who did not die was 38.2. This difference was statistically significant (p = 0.013). However, in the regression analysis, this result was not significant. Age (P=0.04) and NIHSS (P = 0.001) had a meaningful relationship with mortality. Of the 53 patients who were discharged, 5 (9.4%) had recurrence after 3 months. The mean serum level of troponin in patients with recurrence was 43.36 ±55.23 and mean serum troponin level in patients who did not relapse was 40.52 ±93.20. This difference was statistically significant (p = 0.54)
Conclusion: Troponin has no prognostic value on three months mortality and recurrence rate in ischemic stroke patients.

Keywords

Stroke
Troponin
Mortality
Recurrence
  1. Arboix A, Alio J. Acute cardioembolic cerebral infarction: answers to clinical questions. Curr Cardiol Rev 2012; 8(1):54-67.
  2. Tsai CF, Thomas B, Sudlow CL. Epidemiology of stroke and its subtypes in Chinese vs white populations: a systematic review. Neurology 2013; 81(3):264-72.
  3. Adams HP Jr, Bendixen BH, Kappelle LJ, Biller J, Love BB, Gordon DL, et al. Classification of subtype of acute ischemic stroke. Definitions for use in a multicenter clinical trial. TOAST. Trial of org 10172 in acute stroke treatment. Stroke 1993; 24(1):35-41.
  4. Agewall S, Giannitsis E, Jernberg T, Katus H. Troponin elevation in coronary vs. non-coronary disease. Eur Heart J 2011; 32(4): 404-11.
  5. Su YC, Huang KF, Yang FY, Lin SK. Elevation of troponin I in acute ischemic stroke. Peer J 2016; 4:e1866.
  6. Tanindi A, Cemri M. Troponin elevation in conditions other than acute coronary syndromes. Vasc Health Risk Manag 2011; 7:597-603.
  7. Lasek-Bal A, Kowalewska-Twardela T, Gąsior Z, Warsz-Wianecka A, Haberka M, Puz P, et al. The significance of troponin elevation for the clinical course and outcome of first-ever ischaemic stroke. Cerebrovasc Dis 2014; 38(3):212-8.
  8. Thålin C, Rudberg AS, Johansson F, Jonsson F, Laska AC, Nygren AT, et al. Elevated troponin levels in acute stroke patients predict long-term mortality. J Stroke Cerebrovasc Dis 2015; 24(10):2390-6.
  9. Bayir H, Dagli R, Kaymaz H, Yildiz I. Troponin level as a predictor of prognosis in patients with acute ischemic stroke. Crit Care 2015; 19(Suppl 1):P469.
  10. Barber M, Morton JJ, Macfarlane PW, Barlow N, Roditi G, Stott DJ. Elevated troponin levels are associated with sympathoadrenal activation in acute ischaemic stroke. Cerebrovasc Dis 2007; 23(4):260-6.
  11. Etgen T, Baum H, Sander K, Sander D. Cardiac troponins and N-terminal pro-brain natriuretic peptide in acute ischemic stroke do not relate to clinical prognosis. Stroke 2005; 36(2):270-5.
  12. Ali F, Young J, Rabinstein AA, Flemming KD, Fugate JE. Routine troponin measurements are unnecessary to exclude asymptomatic coronary events in acute ischemic stroke patients. J Stroke Cerebrovasc Dis 2016; 25(5):1215-21.
  13.  Seifaddini R, Hamze Moghadam A, Iranmanesh F, Arvan H, Naghibzadeh-Tahami A. The effects of citicoline on cerebrovascular hemodynamic status in ischemic stroke patients. Journal of Kerman University of Medical Sciences 2018; 24(6):480-6.
  14. Dous GV, Grigos AC, Grodman R. Elevated troponin in patients with acute stroke - Is it a true heart attack? Egypt Heart J 2017; 69(3):165-70.
  15. Raza F, Alkhouli M, Sandhu P, Bhatt R, Bove AA. Elevated cardiac troponin in acute stroke without acute coronary syndrome predicts long-term adverse cardiovascular outcomes. Stroke Res Treat 2014; 2014:621650.
  16. Jensen JK, Kristensen SR, Bak S, Atar D, Høilund-Carlsen PF, Mickley H. Frequency and significance of troponin T elevation in acute ischemic. Stroke 2007; 99(1)108-12.
  17. Maoz A, Rosenberg S, Leker RR. Increased high-sensitivity troponin-t levels are associated with mortality after ischemic stroke. J Mol Neurosci 2015; 57(2):160-5.
  18. Batal O, Jentzer J, Balaney B, Kolia N, Hickey G, Dardari Z, et al. The prognostic significance of troponin I elevation in acute ischemic stroke. J Crit Care 2016; 31(1):41-7.
  19. Abdi S, Oveis-Gharan S, Sinaei F, Ghorbani A. Elevated troponin T after acute ischemic stroke: association with severity and location of infarction. Iran J Neurol 2015; 14(1): 35-40.
  20. Miller BR, Alkhachroum AM, Chami T, Sila C. Troponin elevations in ischemic stroke are associated with stroke severity and advanced age. Circulation 2015; 132(Suppl 3):A19723.
  21. Mitsias P, Strubakos C, Penstone P, Dakka A, Jafari-Khouzani K, Schultz L, et al. Specific infarct locations define troponin elevation in acute ischemic stroke. Stroke 2015; 46(Suppl 1): WP46.
  22. von Rennenberg R, Siegerink B, Ganeshan R, Villringer K, Doehner W, Audebert HJ, et al. High-sensitivity cardiac troponin T and severity of cerebral white matter lesions in patients with acute ischemic stroke. J Neurol 2019; 266(1):37-45.
Journal of Kerman University of Medical Sciences
Volume 26, Issue 6
November and December 2019
Pages 473-478

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