Relation Between Cardiac Troponins And In-Hospital Mortality In Right-Sided Stroke Patients


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Atilla R., Duman Atilla Ö., Kuralay F., Yanturalı S., Çiçek M., Manisalı M., ...More

TURKISH JOURNAL OF EMERGENCY MEDICINE, vol.8, no.2, pp.53-58, 2008 (ESCI)

  • Publication Type: Article / Article
  • Volume: 8 Issue: 2
  • Publication Date: 2008
  • Journal Name: TURKISH JOURNAL OF EMERGENCY MEDICINE
  • Journal Indexes: Emerging Sources Citation Index (ESCI), Scopus, TR DİZİN (ULAKBİM)
  • Page Numbers: pp.53-58
  • Dokuz Eylül University Affiliated: Yes

Abstract

Objectives: The association between acute ischemic strokes and cardiovascular disturbances has been established previously. The insula of the right cerebral hemisphere may have a major role in cardiac autonomic control. We investigated if elevated troponin T (cTnT) and troponin I (cTnI), the specific biomarkers of cardiac damage, are independent predictors of in-hospital mortality in right-sided stroke patients.
Materials and Methods: Sixty-six patients with acute ischemic right hemispheric involvement who were admitted to a university hospital during an eight-month period were included in this prospective observational clinical study. The levels of cardiac biomarkers were measured and compared with the in-hospital mortality rates.
Results: Hospital mortality was significantly higher in patients with cTnT>0.1 ng/ml (4 [44.4%] vs 5 [8.8%]; p=0.016) but not in patients with cTnI>1.5 ng/ml (3 [33.3%] vs 6 [10.5%]; p=0.098). Initial National Institute of Health Stroke Scale (NIHSS) scores and Glasgow Coma Scale scores were also significantly higher in patients who were dead in-hospital (median: 16 vs 6; p=0.00, and median: 11 vs 15; p=0.007, respectively). Logistic regression analysis have revealed that elevated cTnT values and NIHSS scores at admission were independent predictors of death in-hospital (p=0.04, [OR 0.03, 95% CI 0.0-0.8]; p=0.046, [OR 2.8, 95% CI 1.082-7.433, respectively).
Conclusion: We conclude that elevated CTnT, but not CTnI, may be an independent predictor of in-hospital mortality in acute ischemic right-sided stroke patients.
Key words: Cardiac troponin; mortality; right-sided stroke.