Electrocardiographic and troponin T changes in acute ischaemic stroke

J Intern Med. 2006 Jun;259(6):592-7. doi: 10.1111/j.1365-2796.2006.01639.x.


Background: The mechanisms explaining morphological electrocardiogram (ECG) changes and increased troponin T (TnT) in acute stroke are unclear. The aims of the present study were to assess the prevalence of ECG and TnT changes in acute ischaemic stroke, to investigate whether ischaemic-like ECG changes correlate to a rise in TnT and to examine whether ECG changes and elevated TnT predict a poor short-time outcome.

Methods: From 2000 to 2002 a total of 279 patients suffering from acute ischaemic stroke were included prospectively in the present study. ECG was carried out at admission and on day 1 in all patients. TnT was analysed at admission and on day 1.

Results: The most frequent ECG changes were: prolonged QTc 36.0%, ST depression 24.5%, atrial fibrillation 19.9% and T wave inversion 17.8%. In logistic regression analyses, ST depression and Q waves were significantly associated with a rise in TnT. TnT was elevated (>0.04 microg L(-1)) in 26 patients (9.6%). In logistic regression analyses, a rise in TnT was significantly associated with a poor short-term outcome (modified Rankin scale >3).

Conclusion: ECG changes are prevalent in acute ischaemic stroke. ST depression and Q waves are related to an increase in TnT, suggesting that these ECG changes may indicate coexisting ischaemic heart disease. A rise in TnT predicts a poor outcome. Patients with acute ischaemic stroke should be offered adequate treatment with secondary prevention and preferably a follow-up with focus on cardiologic as well as neurological aspects.

MeSH terms

  • Acute Disease
  • Adult
  • Aged
  • Aged, 80 and over
  • Arrhythmias, Cardiac / complications*
  • Biomarkers / blood
  • Electrocardiography
  • Female
  • Humans
  • Long QT Syndrome / complications
  • Male
  • Middle Aged
  • Prognosis
  • Prospective Studies
  • Stroke / blood*
  • Stroke / complications*
  • Stroke / physiopathology
  • Troponin T / blood*


  • Biomarkers
  • Troponin T