A troponin study on patients with ischemic stroke, intracerebral hemorrhage and subarachnoid hemorrhage: Type II myocardial infarction is significantly associated with stroke severity, discharge disposition and mortality

Publication date: Available online 20 April 2019Source: Journal of Clinical NeuroscienceAuthor(s): Ayham M. Alkhachroum, Benjamin Miller, Tarek Chami, Curtis Tatsuoka, Cathy SilaAbstractTroponin elevations due to Type II myocardial infarction (T2MI) are associated with hemorrhagic and ischemic strokes but there is little data on stroke severity, troponin elevation and outcome. We studied 1655 patients from a tertiary medical center between 1/2013-4/2015 using multivariate regression analysis for demographics, vascular risk factors, admission stroke severity, laboratory tests, echocardiogram results and discharge disposition. Troponin levels were classified as normal <0.04 ng/ml and high>0.04 ng/ml (critical if>0.5 ng/ml). A T2MI was diagnosed by a trending troponin elevation; patients with type I MI, patients with subdural and epidural hematoma, or hemorrhagic metastatic disease and patients younger than 18 years old were excluded. We had 818 patients with ischemic stroke, 306 with intracerebral hemorrhage (ICH) and 169 with subarachnoid hemorrhage (SAH). Troponin was elevated (>0.04 ng/ml) in 24.1% of ischemic stroke patients, 27.1% in the ICH group, and in 39% of SAH patients. High initial and peak troponin levels were associated with higher National Institutes of Health Stroke Scale (NIHSS) in patients with ischemic stroke (OR 1.04; CI 95%, 1.02–1.07, p = .001) and (OR 1.05; CI 95%, 1.03–1.07, p < .001). In ICH patients, higher initial and pea...
Source: Journal of Clinical Neuroscience - Category: Neuroscience Source Type: research