title: Cardiac troponins and N-terminal pro-brain natriuretic peptide in acute ischemic stroke do not relate to clinical prognosis.
abstract: 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.
authors.affiliation: Department of Neurology, Technical University of Munich, Germany. etgen@neuro.med.tu-muenchen.de
authors.forename: Thorleif
authors.initials: T
authors.lastname: Etgen
authors.forename: Hannsjoerg
authors.initials: H
authors.lastname: Baum
authors.forename: Kerstin
authors.initials: K
authors.lastname: Sander
authors.forename: Dirk
authors.initials: D
authors.lastname: Sander
mesh_terms: 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*
chemical_list: D010446:Peptide Fragments; D019210:Troponin I; D020107:Troponin T; C109794:pro-brain natriuretic peptide (1-76); D020097:Natriuretic Peptide, Brain