title: Cardiac troponin T elevation after stroke: relationships between elevated serum troponin T, stroke location, and prognosis.
abstract: OBJECTIVE
  Elevation of serum cardiac troponin T (cTnT) is regarded as a specific marker of acute coronary syndrome. Serum cTnT can be increased in patients with acute ischemic stroke, but its clinical implications remain unclear. The aim of this study was to identify the relationships between elevated cTnT and stroke severity, location, and prognosis.
  
  
  METHODS
  From January 2005 to December 2006, this study recruited 455 consecutive patients who were admitted to Kangbuk Samsung Hospital due to acute ischemic stroke within 3 days of onset, which was confirmed by diffusion magnetic resonance imaging. A total of 416 patients was finally included and divided into 2 groups: an elevated cTnT group (n=45) and a normal cTnT group (n=371). The short-term prognosis was assessed by 30-day modified Rankin Scale responder analysis was compared between the two groups.
  
  
  RESULTS
  Serum cTnT was elevated in 10.8% of cases, with elevated cTnT associated with greater stroke severity, as assessed by the National Institutes of Health Stroke Scale score, Insular-lobe involvement was more common in patients with elevated cTnT than in the normal cTnT group. Short-term prognosis was more unfavorable in the elevated cTnT group than in the normal cTnT group. Multivariate regression analysis indicated that elevated cTnT was independently related to insular involvement, cardioembolism, and unfavorable outcome.
  
  
  CONCLUSIONS
  Elevated cTnT in acute ischemic stroke was associated with severe neurological deficits at stroke onset and damages to the insular lobe. The outcome of acute ischemic stroke was worse for patients with elevated cTnT than for those with normal cTnT. The pathomechanism underlying acute ischemic stroke and subclinical myocardial damage warrants further study.
authors.affiliation: Department of Neurology, Kangbuk Samsung Hospital, Sungkyunkwan University School of Medicine, Seoul, Korea.
authors.forename: Hwa-Suk
authors.initials: HS
authors.lastname: Song
authors.forename: Jang-Hyun
authors.initials: JH
authors.lastname: Back
authors.forename: Dong-Kwan
authors.initials: DK
authors.lastname: Jin
authors.forename: Pil-Wook
authors.initials: PW
authors.lastname: Chung
authors.forename: Heui-Soo
authors.initials: HS
authors.lastname: Moon
authors.forename: Bum-Chun
authors.initials: BC
authors.lastname: Suh
authors.forename: Yong-Bum
authors.initials: YB
authors.lastname: Kim
authors.forename: Byung Moon
authors.initials: BM
authors.lastname: Kim
authors.forename: Hee Yeon
authors.initials: HY
authors.lastname: Woo
authors.forename: Yong Taek
authors.initials: YT
authors.lastname: Lee
authors.forename: Kwang-Yeol
authors.initials: KY
authors.lastname: Park