Departments of Neurology, Justus Liebig University Giessen, Giessen, Germany.
BMC Neurol. 2012 Jul 17;12:58. doi: 10.1186/1471-2377-12-58.
Cardiac troponin-I (cTNI) is highly specific biomarker to prove myocardial damage, e.g. in acute coronary syndrome (ACS). However, it occurs in other conditions as well. We therefore analysed cTNI increase in patients after generalized convulsive seizure.
Consecutive patients admitted with acute generalized convulsive seizure were included in case of cTNI measurement on admission. Among 898 selected cases, 53 patients were referred secondary to our department; in 845 cases cTNI measurements on admission were available. In case of multiple admissions (81 cases), only the first admission entered our analysis. In 17 patients elevated cTNI was determined due to ACS; in one patient a myocarditis was found. 5 patients suffered of relevant renal insufficiency. Finally 741 patients were included in the analysis. A cTNI cut-off level of ≥ 0.1 ng/ml was considered. Factors associated with a cTNI increase were analysed subsequently.
The mean age of the study population (n = 741) was 47.8 years (SD ± 18.6), 40.9% were female. In 50 patients (6.7%) a cTNI elevation of unknown origin was found; no obvious cardiac involvement could be detected in these patients who all remained asymptomatic. A vascular risk profile (including at least hypertension, hypercholesterolemia or diabetes) (OR = 3.62; CI: 1.59 to 8.21; p = 0.001) and elevated creatine kinase on admission (OR = 2.36; CI: 1.26 to 4.39; p = 0.002) were independent factors associated with cTNI release.
cTNI release occurs in patients with generalized convulsive seizure with predominance in patients with vascular risk profile.
心肌肌钙蛋白 I（cTNI）是一种高度特异性的生物标志物，可用于证明心肌损伤，例如在急性冠状动脉综合征（ACS）中。然而，它也会在其他情况下出现。因此，我们分析了全身性强直-阵挛性癫痫发作后患者 cTNI 的升高情况。
连续纳入入院时进行 cTNI 检测的急性全身性强直-阵挛性癫痫发作患者。在 898 例入选病例中，53 例因我院转科；在 845 例入院时 cTNI 检测的病例中，81 例存在多次入院，仅对首次入院的病例进行了分析。在 17 例 cTNI 升高的患者中，确定 ACS 为病因；在 1 例患者中发现心肌炎。5 例患者存在相关的肾功能不全。最终有 741 例患者纳入分析。将 cTNI 截断值设为≥0.1ng/ml。随后分析与 cTNI 升高相关的因素。
研究人群（n=741）的平均年龄为 47.8 岁（SD±18.6），女性占 40.9%。50 例（6.7%）患者 cTNI 升高的原因不明；这些患者无明显的心脏受累，且均无症状。血管风险状况（包括至少高血压、高胆固醇血症或糖尿病）（OR=3.62；95%CI：1.59 至 8.21；p=0.001）和入院时肌酸激酶升高（OR=2.36；95%CI：1.26 至 4.39；p=0.002）是与 cTNI 释放相关的独立因素。
全身性强直-阵挛性癫痫发作患者会发生 cTNI 释放，具有血管风险状况的患者更易发生。
