Král Michal, Šaňák Daniel, Veverka Tomáš, Hutyra Martin, Vindiš David, Bártková Andrea, Kunčarová Anna, Dorňák Tomáš, Čecháková Eva, Herzig Roman, Langová Kateřina, Kaňovský Petr, Školoudík David
Comprehensive Stroke Center, Department of Neurology, University Hospital, Olomouc, Czech Republic.
Department of Internal Medicine I - Cardiology, University Hospital and Faculty of Medicine and Dentistry, Palacký University, Olomouc, Czech Republic.
Int J Cardiol. 2015 Feb 15;181:127-32. doi: 10.1016/j.ijcard.2014.12.027. Epub 2014 Dec 3.
The troponin T (cTnT) is frequently elevated in acute ischemic stroke (AIS) patients. However, the relationship, if any, between the cTnT level and brain infarction remains to be established. The aim was to investigate the possible correlation between the location and volume of brain infarction and the cardiac cTnT serum level in AIS patients.
The study consisted of consecutive AIS patients admitted within 12h of stroke onset. The location and volume of the acute ischemic lesion was assessed with magnetic resonance imaging. Standard laboratory tests, including cTnT and repeated electrocardiograms, were performed at admission and after 4h. Correlations between the cTnT level and the location and volume of brain infarction and baseline parameters were tested with a Spearman correlation coefficient. Univariate and multiple logistic regression analysis (LRA) were used to determine the possible predictors of cTnT elevation.
Out of the 200 enrolled patients, elevated cTnT was present in 71 (36%). No correlation was found between the cTnT serum levels and the location (P>0.05) nor volume of brain infarction (r=0.05, P=0.48). LRA identified creatinine (OR: 1.26 per 10μmol/L increase; 95% CI: 1.043-1.524), NT-proBNP (OR: 1.05 per 100μg/L increase; 95% CI: 1.018-1.093) and male gender (OR: 3.674; 95% CI: 1.025-13.164) as significant independent predictors of pathological elevation of cTnT.
Although elevated cTnT serum level is relatively frequent in AIS patients within the first 12h of stroke onset, it is not related to the location or volume of brain infarction.
http://www.clinicaltrials.gov (No. NCT01541163).
急性缺血性卒中（AIS）患者的肌钙蛋白T（cTnT）常升高。然而，cTnT水平与脑梗死之间的关系（若存在）仍有待确定。目的是研究AIS患者脑梗死的部位和体积与心脏cTnT血清水平之间可能存在的相关性。
该研究纳入卒中发作12小时内连续入院的AIS患者。采用磁共振成像评估急性缺血性病变的部位和体积。入院时及4小时后进行包括cTnT和重复心电图在内的标准实验室检查。用Spearman相关系数检验cTnT水平与脑梗死部位和体积及基线参数之间的相关性。采用单因素和多因素逻辑回归分析（LRA）确定cTnT升高的可能预测因素。
在200例纳入研究的患者中，71例（36%）cTnT升高。未发现cTnT血清水平与脑梗死部位（P>0.05）及体积之间存在相关性（r=0.05，P=0.48）。LRA确定肌酐（每升高10μmol/L，OR：1.26；95%CI：1.043 - 1.524）、N末端脑钠肽前体（NT-proBNP）（每升高100μg/L，OR：1.05；95%CI：1.018 - 1.093）和男性（OR：3.674；95%CI：1.025 - 13.164）是cTnT病理性升高的显著独立预测因素。
虽然卒中发作后12小时内AIS患者cTnT血清水平升高相对常见，但它与脑梗死的部位或体积无关。
