Document Type : Special Articles


Department of Neurology, School of Medicine, Shariati Hospital, Tehran University of Medical Sciences, Tehran, Iran.


Background: Serum troponin elevation, characteristic of ischemic myocardial injury, has been observed in some acute ischemic stroke (AIS) patients. Its cause and significance are still controversial. The purpose of this study is to find determinants of troponin elevation and its relationship with stroke severity and location.Methods:Between January 2013 and August 2013, 114 consecutive AIS patients confirmed by diffusion- weighted magnetic resonance imaging were recruited in this study. Serum troponin T level was measured as part of routine laboratory testing on admission. Ten lead     standard     electrocardiogram    (ECG)     was performed and stoke severity was assessed based on National Institutes of Health Stroke Scale (NIHSS).Results: Troponin T was elevated in 20 (17.6%) of 114 patients. Patients with elevated troponin were more   likely   to   have   higher   age,   higher   serum creatinine  and  ischemic  ECG  changes.  Troponin levels were higher in patients with more severe stroke measured  by  NIHSS  [7.96  (6.49-9.78)  vs.  13.59 (10.28-18.00)].  There  was  no  association  between troponin and locations of stroke and atrial fibrillation. There were 6 (5%) patients with elevated troponin in the presence of normal creatinine and ECG.Conclusion:  Stroke  severity,  not  its  location,  was associated   with   higher   troponin   levels.   Abnormal troponin levels are more likely, but not exclusively, to be due to cardiac and renal causes than cerebral ones.