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KMID : 1130620080040020075
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Journal of Clinical Neurology
2008 Volume.4 No. 2 p.75 ~ p.83
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Cardiac Troponin T Elevation After Stroke:Relationships Between Elevated Serum Troponin T,Stroke Location, and Prognosis
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Song Hwa-Suk
Suh Bum-Chun
Moon Heui-Soo
Chung Pil-Wook
Kim Byung-Moon
Park Kwang-Yeol
Woo Hee-Yeon
Back Jang-Hyun
Jin Dong-Kwan
Kim Young-Bum
Lee Young-Taek
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Abstract
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Background and Purpose: 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.
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KEYWORD
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Serum cardiac troponin T (cTnT), Diffusion magnetic resonance imaging, Acute myocardial infarction
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