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Med Klin Intensivmed Notfmed. 2015 Nov 12. [Epub ahead of print]

[Troponin elevation in ischemic stroke patients].

[Article in German]
Nolte CH1,2, Scheitz JF3,4, Endres M3,4,5,6,7.

Author information

  • 1Klinik für Neurologie, Charité - Universitätsmedizin Berlin, Campus Benjamin Franklin, Hindenburgdamm 30, 12203, Berlin, Deutschland. christian.nolte@charite.de.
  • 2Center for Stroke Research Berlin, Charité - Universitätsmedizin Berlin, Berlin, Deutschland. christian.nolte@charite.de.
  • 3Klinik für Neurologie, Charité - Universitätsmedizin Berlin, Campus Benjamin Franklin, Hindenburgdamm 30, 12203, Berlin, Deutschland.
  • 4Center for Stroke Research Berlin, Charité - Universitätsmedizin Berlin, Berlin, Deutschland.
  • 5Excellence Cluster NeuroCure, Charité - Universitätsmedizin Berlin, Berlin, Deutschland.
  • 6Deutsches Zentrum für Neurodegenerative Erkrankungen (DZNE), Berlin, Deutschland.
  • 7Deutsches Zentrum für Herz-Kreislauf-Forschung (DZHK), Berlin, Deutschland.

Abstract

Cerebrovascular and cardiovascular diseases are major causes of death and disability worldwide. Ischemic stroke is a frequent complication in cardiac diseases and, vice versa, cardiac complications commonly cause early clinical worsening and death after stroke. In the emergency setting, cardiac biomarkers (preferably troponin, cTn) are measured frequently in patients presenting with acute ischemic stroke. The measurement of cTn is recommended by the guidelines for early management of patients with acute ischemic stroke from the American Heart Association. In case of pathologic cTn elevation, physicians are confronted with diagnostic and therapeutic uncertainties. Up-to-date recommendations on interpretation and consecutive actions remain ambiguous because cTn elevations may originate from causes other than acute coronary disease and because clinical signs and symptoms of acute coronary disease may be obscured by neurological deficits of the stroke. The application of modern, high-sensitive cTn assays that detect even minor cTn elevations has rather aggravated the dilemma of how to interpret this finding in patients with ischemic stroke.This article gives an overview on possible mechanisms of the frequently observed cTn elevation in ischemic stroke patients and offers help on interpretation and meaningful actions.

KEYWORDS:

Acute coronary syndrome; Biomarkers; Cerebral infarction; Myocardial infarction; Prognosis

PMID:
26564181
DOI:
10.1007/s00063-015-0116-x
[PubMed - as supplied by publisher]
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