[Myocardial injury in acute stroke assessed by troponin I].
BACKGROUND
Acute ischaemic or haemorrhagic cerebrovascular events may produce myocardial damage. Cardiac troponin I is an indicator of cardiac cell injury with very high sensitivity and specificity.


METHODS
We measured troponin I in 149 acute stroke patients admitted to the stroke unit of Trondheim University Hospital, Norway, in January to June 1999.


RESULTS
40 patients (27%) had troponin I values at 0.4 microgram/l or higher, indicating myocardial injury. 10 patients (6.7%) had troponin I values above 2.0 micrograms/l. Similarly, the mean value of CK-MB vas higher in the patients with myocardial injury, and these patients had more often ECG findings suggesting myocardial ischaemia. Patients with myocardial injury had a higher rate of previous TIA and heart failure. ECG showed atrial fibrillation in 13 of 39 patients with myocardial damage. Patients with detectable levels of troponin I had more embolic brain infarctions than thrombotic brain infarctions. Patients with myocardial injury did more often have abnormal values of CRP. 9 of 10 patients with troponin I-values above 2.0 micrograms/l had abnormal CRP values. No differences in glycosylated haemoglobin, cholesterol, heart rate, blood pressure or body temperature were found. Patients with the highest troponin I values had lower systolic blood pressure, and a higher heart rate, but these differences were not statistically significant. Patients with troponin I values above 2.0 micrograms/l had lower functional and neurological scores at admittance. Patients with myocardial injury were more often discharged to nursing homes.


CONCLUSIONS
Many patients with an acute stroke have at the same time a myocardial injury, determined by elevated troponin I values.
Troøyen
M
M
Det medisinske fakultet Norges teknisk-naturvitenskapelige universitet 7489 Trondheim.
Indredavik
B
B
Rossvoll
O
O
Slørdahl
S A
SA
D000203:Activities of Daily Living; D000208:Acute Disease; D000368:Aged; D015415:Biomarkers / Q000032:analysis*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D017202:Myocardial Ischemia / Q000097:blood* / Q000175:diagnosis / Q000209:etiology; D009206:Myocardium / Q000201:enzymology / Q000473:pathology; D020521:Stroke / Q000097:blood* / Q000175:diagnosis / Q000209:etiology; D019210:Troponin I / Q000097:blood*
D015415:Biomarkers; D019210:Troponin I