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Review
. 2017 Sep;69(3):165-170.
doi: 10.1016/j.ehj.2017.01.005. Epub 2017 Feb 14.

Elevated troponin in patients with acute stroke - Is it a true heart attack?

George V Dous  1 , Angela C Grigos  2 , Richard Grodman  3
Affiliations
Review

Elevated troponin in patients with acute stroke - Is it a true heart attack?

George V Dous et al. Egypt Heart J. 2017 Sep.

Abstract

Although the prognostic value of a positive troponin in an acute stroke patient is still uncertain, it is a commonly encountered clinical situation given that Ischemic Heart Disease (IHD) and cerebrovascular disease (CVD) frequently co-exist in the same patient and share similar risk factors. Our objectives in this review are to (1) identify the biologic relationship between acute cerebrovascular stroke and elevated troponin levels, (2) determine the pathophysiologic differences between positive troponin in the setting of acute stroke versus acute myocardial infarction (AMI), and (3) examine whether positive troponin in the setting of acute stroke has prognostic significance. We also will provide an insight analysis of some of the available studies and will provide guidance for a management approach based on the available data according to the current guidelines.

Keywords: ACS, acute coronary syndrome; AMI, acute myocardial infarction; CAD, Coronary Artery Disease; CAST, Chinese Acute Stroke Trial; CK-MB, Creatine Kinase-MB; CT, computed tomography; CVD, Cardiovascular Disease; DAPT, dual antiplatelet therapy; ECG, electrocardiogram; ICH, intracranial hemorrhage; IHD, Ischemic Heart Disease; IST, International Stroke Trial; LDL, low-density lipoprotein; LV, left ventricular; MI, myocardial infarction; Myocardial infarction; NHS, neurogenic heart syndrome; Neurogenic heart syndrome; SAH, subarachnoid hemorrhage; Stroke; TIA, Transient Ischemic Attacks; TRELAS, The Troponin Elevation in Acute Ischemic Stroke; Troponin; cTnI, Troponin I; cTnT, Troponin T.

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Figures

Diagram 1
Diagram 1
Illustrates the pathophysiologic mechanism of increase catecholamine and the release of cardiac enzymes.
See this image and copyright information in PMC

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