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.