Baseline Troponin T level in stroke and its association with stress cardiomyopathy

Liesirova, Kai Timo; Abela, Eugenio; Pilgrim, Thomas; Bickel, Laura; Meinel, Thomas Raphael; Meisterernst, Julia Anne; Verma, Rajeev Kumar; Sarikaya, Hakan; Heldner, Mirjam Rachel; Dobrocky, Tomas; Siqueira, E.; El-Koussy, Marwan; Fischer, Urs; Gralla, Jan; Arnold, Marcel; Mattle, Heinrich; Hsieh, Kety Wha-Vei; Jung, Simon (2018). Baseline Troponin T level in stroke and its association with stress cardiomyopathy. PLoS ONE, 13(12), e0209764. Public Library of Science 10.1371/journal.pone.0209764

[img]
Preview
Text
journal.pone.0209764.pdf - Published Version
Available under License Creative Commons: Attribution (CC-BY).

Download (682kB) | Preview

BACKGROUND: Differential diagnosis of elevated high sensitive Troponin T (hsTnT) in acute ischemic stroke includes myocardial infarction (MI) and neurogenic stunned myocardium (NSM). The aim of this study was to identify factors associated with baseline hsTnT levels and MI or NSM in acute ischemic stroke. METHODS: We studied 204 consecutive patients of the prospective acquired Bern Stroke Database with acute ischemic stroke diagnosed by brain MR. All patient histories and cardiac examinations were reviewed retrospectively. Volumetry of lesions on diffusion and perfusion weighted brain imaging (circular singular value decomposition, Tmax >6sec) was performed. Voxel based analysis was performed to identify brain areas associated with hsTnT elevation. Linear regression analysis was used to identify predictors of baseline hsTnT levels and myocardial infarction. RESULTS: Elevated hsTnT was observed in 58 of the 204 patients (28.4). The mean age was 68.3 years in the normal hsTnT group and 69.7 years in the elevated hsTnT group. Creatinine (p<0.001, OR 6.735, 95 CI 58.734-107.423), baseline NIHSS score (p = 0.029, OR 2.207, 95 CI 0.675-12.096), ST segment depression (p = 0.025, OR 2.259, 95 CI 2.419-35.838), and negative T waves in baseline ECG (p = 0.002, OR 3.209, 95 CI 13.007-54.564) were associated with hsTnT elevation, while infarct location and size were not. Coronary angiography was performed in 30 of the 204 patients (14.7) and myocardial infarction was diagnosed in 7 of them (23.3). Predictive factors for myocardial infarction could not be identified. CONCLUSION: Elevated baseline baseline hsTnT was associated with NIHSS, creatinine, ST segment depression and inverted T waves, but not with stroke location or size. None of the factors was helpful to differentiate MI and NSM. Therefore, ancillary investigations such as coronary angiography, cardiac MRI or both may be needed to solve the differential diagnosis.

Item Type:

Journal Article (Original Article)

Division/Institute:

04 Faculty of Medicine > Department of Head Organs and Neurology (DKNS) > Clinic of Neurology
04 Faculty of Medicine > Department of Radiology, Neuroradiology and Nuclear Medicine (DRNN) > Institute of Diagnostic and Interventional Neuroradiology
04 Faculty of Medicine > Department of Cardiovascular Disorders (DHGE) > Clinic of Cardiology

UniBE Contributor:

Liesirova, Kai Timo; Abela, Eugenio; Pilgrim, Thomas; Bickel, Laura; Meinel, Thomas Raphael; Meisterernst, Julia Anne; Verma, Rajeev Kumar; Sarikaya, Hakan; Heldner, Mirjam Rachel; Dobrocky, Tomas; El-Koussy, Marwan; Fischer, Urs; Gralla, Jan; Arnold, Marcel; Mattle, Heinrich; Hsieh, Kety Wha-Vei and Jung, Simon

Subjects:

600 Technology > 610 Medicine & health

ISSN:

1932-6203

Publisher:

Public Library of Science

Language:

English

Submitter:

Panagiota Milona

Date Deposited:

22 Jan 2019 15:08

Last Modified:

07 Feb 2019 19:47

Publisher DOI:

10.1371/journal.pone.0209764

PubMed ID:

30596715

BORIS DOI:

10.7892/boris.124723

URI:

https://boris.unibe.ch/id/eprint/124723

Actions (login required)

Edit item Edit item
Provide Feedback