The Clinical Importance of Troponin Elevation in Ischaemic Cerebrovascular Events: A Clinical Review

Abstract

Cardiac troponin I (cTnI) and troponin T are recognized as sensitive and specific markers of cardiac injury and their elevation can occur after ischaemic stroke in the absence of primary cardiac causes. The background and clinical importance of stroke-related myocardial injury is not well understood. We made a systematic review to collect articles focusing on troponin elevation in ischaemic cerebrovascular diseases. Based on systematic research raised troponins were associated with unfavourable outcome and increased mortality rates. Despite of extensive literature it is still a matter of debate whether raised troponins are caused by a preceeding myocardial event with subsequent cardioembolic stroke or they represent cardiac injury due to elevated levels of circulating catecholamines. The majority of available evidence supports the hypothesis that elevated catecholamine levels result from a nonspecific physiologic stress response, though the mechanism has not been definitively established. On the other hand, there are two ongoing trials to clarify the background of myocardial injury in ischaemic stroke.