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

Rıdvan Atilla; Özge Duman; Filiz Kuralay; Sedat Yanturalı; Metin Çiçek; Metin Manisalı; Baflak Bingöl Çakırlı; Cenker Eken

Rıdvan Atilla¹, Özge Duman², Filiz Kuralay³, Sedat Yanturalı¹, Metin Çiçek¹, Metin Manisalı⁴, Baflak Bingöl Çakırlı³, Cenker Eken⁵

¹Departments Of Emergency Medicine,medicine Faculty Of Dokuz Eylul University, İzmir
²Tepecik Training And Research Hospital, İzmir
³Departments Of Biochemistry,medicine Faculty Of Dokuz Eylul University, İzmir
⁴Departments Of Radiology,medicine Faculty Of Dokuz Eylul University, İzmir
⁵Department Of Emergency Medicine, Medicine Faculty Of Akdeniz University, Antalya

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.