Cardiac troponins and N-terminal pro-brain natriuretic peptide in acute ischemic stroke do not relate to clinical prognosis.
OBJECTIVE
The prognostic value of cardiac troponins and natriuretic peptide in acute ischemic stroke is uncertain. We measured cardiac troponin T (cTnT), cardiac troponin I (cTnI), and N-terminal pro-brain natriuretic peptide (NT-proBNP) at admission in acute ischemic stroke patients without evident myocardial damage.


METHODS
In 174 consecutive patients with MRI-confirmed ischemic stroke, serial measurements of cTnT, cTnI, and NT-proBNP were performed at 3 different time points in the hyperacute phase (at admission, on days 1 and 2). Relation of laboratory values to risk factors, stroke subtype classification, and clinical outcome after 3 months was analyzed.


RESULTS
The highest proportion of raised parameters was found at day 2 for cTnI in 8 of 103 (7.8%), at day 3 for cTnT in 8 of 174 (4.6%), and NT-proBNP in 114 of 174 (65.5%) patients. Proportion of patients with good outcome was significantly reduced in the group with highest NT-proBNP quartile. However, using multivariate regression analysis, no significant relation to morbidity and mortality was found for cTnT, cTnI, or NT-proBNP. Significant impact on the outcome was detected for lesion size, insular involvement, sex, age, and stroke severity.


CONCLUSIONS
NT-proBNP is raised in nearly two thirds of acute stroke patients, whereas elevated cardiac troponins are found only in a small number of acute ischemic stroke patients. Neither NT-proBNP nor cardiac troponins influence clinical outcome if other risk factors are considered.
Etgen
Thorleif
T
Department of Neurology, Technical University of Munich, Germany. etgen@neuro.med.tu-muenchen.de
Baum
Hannsjoerg
H
Sander
Kerstin
K
Sander
Dirk
D
D000367:Age Factors; D000368:Aged; D002545:Brain Ischemia / Q000473:pathology; D004562:Electrocardiography; D005260:Female; D006801:Humans; D007511:Ischemia; D008297:Male; D008875:Middle Aged; D020097:Natriuretic Peptide, Brain / Q000737:chemistry / Q000378:metabolism*; D010446:Peptide Fragments / Q000737:chemistry; D011379:Prognosis; D011446:Prospective Studies; D017434:Protein Structure, Tertiary; D012044:Regression Analysis; D012307:Risk Factors; D012737:Sex Factors; D020521:Stroke; D013997:Time Factors; D016896:Treatment Outcome; D019210:Troponin I / Q000737:chemistry / Q000378:metabolism*; D020107:Troponin T / Q000737:chemistry / Q000378:metabolism*
D010446:Peptide Fragments; D019210:Troponin I; D020107:Troponin T; C109794:pro-brain natriuretic peptide (1-76); D020097:Natriuretic Peptide, Brain