Highly sensitive troponin T in patients with acute ischemic stroke

Eur Neurol. 2012;68(5):287-93. doi: 10.1159/000341340. Epub 2012 Oct 5.

Abstract

Background: Newly developed troponin assays have superior diagnostic and prognostic performance in acute coronary syndrome (ACS), when compared to conventional troponin assays; however, highly sensitive troponin has not been evaluated in patients with acute ischemic stroke.

Methods: Highly sensitive troponin T (hsTnT) was measured daily during the first 4 days in 193 consecutive patients with acute ischemic stroke without overt ACS or atrial fibrillation. The patients were previously tested normal with a fourth-generation TnT assay. The patients were followed for 47 months, with all-cause and cardiovascular mortality end-points.

Results: A total of 33.7% of the patients had hsTnT levels >14 ng/l following admission. Patients with increased hsTnT were older, had decreased hemoglobin levels and increased creatinine, NT-proBNP and CRP levels. hsTnT concentrations at admission were significantly higher in decedents than in survivors. After adjustment for stroke severity, C-reactive protein, age, NT-proBNP and prior heart and/or renal failure, hsTnT levels were not a significant predictor of long-term all-cause or cardiovascular mortality.

Conclusion: Elevated levels of hsTnT are frequently present in patients with acute ischemic stroke previously tested normal with a fourth-generation TnT assay. hsTnT did not provide additional prognostic information in these subjects.

MeSH terms

  • Acute Coronary Syndrome / blood*
  • Acute Coronary Syndrome / diagnosis
  • Aged
  • Aged, 80 and over
  • C-Reactive Protein / metabolism*
  • Female
  • Humans
  • Male
  • Middle Aged
  • Peptide Fragments / blood*
  • Prognosis
  • Sensitivity and Specificity
  • Stroke / blood*
  • Stroke / diagnosis
  • Troponin T / blood*

Substances

  • Peptide Fragments
  • Troponin T
  • C-Reactive Protein