Elevation of troponins as a cardioembolic etiology marker in ischemic stroke

Ischemic stroke may be due to several mechanisms. A cardioembolism is defined as an arterial occlusion secondary to a embolus that arises from the heart in a patient with at least one risk factor or condition for the generation of this pathology. Troponins are sensitive an...

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Autores principales: Gordo, R, Galleguillo, G, Fuentes, V, Lucero, N, Buonanotte, CF
Formato: Artículo revista
Lenguaje:Español
Publicado: Universidad Nacional Córdoba. Facultad de Ciencias Médicas. Secretaria de Ciencia y Tecnología 2019
Materias:
stroke
troponin
risk factors
intracranial embolism
accidente cerebrovascular
troponina
factores de riesgo
embolia intracraneal
Acceso en línea:https://revistas.unc.edu.ar/index.php/med/article/view/25882
Aporte de:
Revista de la Facultad de Ciencias Médicas de Córdoba de Universidad Nacional de Córdoba
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institution Universidad Nacional de Córdoba
institution_str I-10
repository_str R-327
container_title_str Revista de la Facultad de Ciencias Médicas de Córdoba
language Español
format Artículo revista
topic stroke
troponin
risk factors
intracranial embolism
accidente cerebrovascular
troponina
factores de riesgo
embolia intracraneal
spellingShingle stroke
troponin
risk factors
intracranial embolism
accidente cerebrovascular
troponina
factores de riesgo
embolia intracraneal
Gordo, R
Galleguillo, G
Fuentes, V
Lucero, N
Buonanotte, CF
Elevation of troponins as a cardioembolic etiology marker in ischemic stroke
topic_facet stroke
troponin
risk factors
intracranial embolism
accidente cerebrovascular
troponina
factores de riesgo
embolia intracraneal
author Gordo, R
Galleguillo, G
Fuentes, V
Lucero, N
Buonanotte, CF
author_facet Gordo, R
Galleguillo, G
Fuentes, V
Lucero, N
Buonanotte, CF
author_sort Gordo, R
title Elevation of troponins as a cardioembolic etiology marker in ischemic stroke
title_short Elevation of troponins as a cardioembolic etiology marker in ischemic stroke
title_full Elevation of troponins as a cardioembolic etiology marker in ischemic stroke
title_fullStr Elevation of troponins as a cardioembolic etiology marker in ischemic stroke
title_full_unstemmed Elevation of troponins as a cardioembolic etiology marker in ischemic stroke
title_sort elevation of troponins as a cardioembolic etiology marker in ischemic stroke
description Ischemic stroke may be due to several mechanisms. A cardioembolism is defined as an arterial occlusion secondary to a embolus that arises from the heart in a patient with at least one risk factor or condition for the generation of this pathology. Troponins are sensitive and specific markers of heart injury. It has been noted that between 5 and 34% of patients with ischemic stroke have elevated troponins. It was decided to carry out the following study based on the hypothesis that the elevation of troponins in the first 24 hours in patients with ischemic stroke indicates the presence of cardioembolic etiologies. The objective was to analyze the relationship between troponin elevation in the first 24 hours and the different causal etiologies of cerebrovascular disease in patients with ischemic stroke who were admitted to the National Hospital of Clinics in the city of Córdoba. A cross-sectional analytical observational study of patients diagnosed with ischemic stroke admitted to the neurology service of the National Hospital of Clinics between March 2018 and March 2019 was carried out.  Patients underwent a standard diagnostic evaluation of ischemic stroke. Quantitative troponin measurements were made by analysis with an integrated system of clinical chemistry and immunochemistry Dimension EXL 200 Siemens, with electrochemiluminescence method (EQLA); a negative troponin was considered any value less than 0.056 ng / mL, while a positive troponin was defined as any value greater than or equal to 0.056 ng / ml. 79 patients participated in the study of which 23 (29.11%) presented troponin elevation, without electrocardiographic signs of Acute Myocardial Infarction. An association was found between the presence of cardioembolic etiologies and troponin elevation (p <0.0001) such as atrial fibrillation, mitral stenosis, dilated cardiomyopathy, among others. In this study we demonstrated an independent association between elevated troponin levels and the presence of embolic etiologies, compared to the presence of non-cardioembolic etiologies. Our findings suggest that elevation during the first 24 hours of cardiac troponins may represent a marker of cardioembolic etiology.
publisher Universidad Nacional Córdoba. Facultad de Ciencias Médicas. Secretaria de Ciencia y Tecnología
publishDate 2019
url https://revistas.unc.edu.ar/index.php/med/article/view/25882
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spelling I10-R327-article-258822024-08-27T18:26:33Z Elevation of troponins as a cardioembolic etiology marker in ischemic stroke Elevación de troponinas como marcador de etiología cardioembólica en ACV isquémico Gordo, R Galleguillo, G Fuentes, V Lucero, N Buonanotte, CF stroke troponin risk factors intracranial embolism accidente cerebrovascular troponina factores de riesgo embolia intracraneal Ischemic stroke may be due to several mechanisms. A cardioembolism is defined as an arterial occlusion secondary to a embolus that arises from the heart in a patient with at least one risk factor or condition for the generation of this pathology. Troponins are sensitive and specific markers of heart injury. It has been noted that between 5 and 34% of patients with ischemic stroke have elevated troponins. It was decided to carry out the following study based on the hypothesis that the elevation of troponins in the first 24 hours in patients with ischemic stroke indicates the presence of cardioembolic etiologies. The objective was to analyze the relationship between troponin elevation in the first 24 hours and the different causal etiologies of cerebrovascular disease in patients with ischemic stroke who were admitted to the National Hospital of Clinics in the city of Córdoba. A cross-sectional analytical observational study of patients diagnosed with ischemic stroke admitted to the neurology service of the National Hospital of Clinics between March 2018 and March 2019 was carried out.  Patients underwent a standard diagnostic evaluation of ischemic stroke. Quantitative troponin measurements were made by analysis with an integrated system of clinical chemistry and immunochemistry Dimension EXL 200 Siemens, with electrochemiluminescence method (EQLA); a negative troponin was considered any value less than 0.056 ng / mL, while a positive troponin was defined as any value greater than or equal to 0.056 ng / ml. 79 patients participated in the study of which 23 (29.11%) presented troponin elevation, without electrocardiographic signs of Acute Myocardial Infarction. An association was found between the presence of cardioembolic etiologies and troponin elevation (p <0.0001) such as atrial fibrillation, mitral stenosis, dilated cardiomyopathy, among others. In this study we demonstrated an independent association between elevated troponin levels and the presence of embolic etiologies, compared to the presence of non-cardioembolic etiologies. Our findings suggest that elevation during the first 24 hours of cardiac troponins may represent a marker of cardioembolic etiology. Las lesiones isquémicas cerebrales pueden ocurrir por varios mecanismos. Una cardioembolia se define como una oclusión arterial secundaria a un émbolo que surge del corazón en un paciente con al menos una condición de riesgo para la generación de esta patología. Las troponinas son marcadores sensibles y específicos de lesión cardíaca. Se ha observado que entre el 5 y el 34 % de los pacientes con ACV isquémico presentan elevación de estas. Partiendo de la hipótesis de que la elevación de troponinas en las primeras 24 hs en pacientes con ACV isquémico indica la presencia de etiologías cardioembólicas se decidió realizar el siguiente estudio. El objetivo fue analizar la relación existente entre la elevación de troponinas en las primeras 24 hs y las diferentes etiologías causales de enfermedad cerebrovascular en pacientes con ACV isquémico que cursaron internación en el Hospital Nacional de Clínicas de la ciudad de Córdoba. Se realizó un estudio observacional analítico transversal de los pacientes con diagnóstico de ACV isquémico internados en el servicio de neurología del Hospital Nacional de Clínicas entre marzo del 2018 y marzo del 2019.Los pacientes fueron sometidos a una evaluación diagnóstica estándar de ACV isquémico. Las medidas cuantitativas de troponinas se realizaron mediante análisis con un sistema integrado de química clínica e inmunoquímica Dimension EXL 200 Siemens, con método de electroquimioluminiscencia (EQLA); una troponina negativa se consideró cualquier valor menor a 0,056 ng / mL, mientras que una troponina positiva se definió como cualquier valor mayor o igual a 0,056 ng / ml.  En total 79 pacientes participaron del estudio de los cuales 23 (29,11%) presentaron elevación de troponinas, sin signos electrocardiográficos de Infarto Agudo de Miocardio. Se encontró una asociación entre la presencia de etiologías cardioembólicas y elevación de troponinas (p<0,0001) tales como fibrilación auricular, estenosis mitral, cardiomiopatía dilatada, entre otras. En este estudio demostramos una asociación independiente entre la elevación de troponinas y la presencia de etiologías cardioembólicas, comparado con la presencia de etiologías no cardioembólicas. Nuestros hallazgos sugieren que la elevación durante las primeras 24 hs de las troponinas cardíacas puede representar un marcador de etiología cardioembólica.  Universidad Nacional Córdoba. Facultad de Ciencias Médicas. Secretaria de Ciencia y Tecnología 2019-10-22 info:eu-repo/semantics/article info:eu-repo/semantics/publishedVersion application/pdf https://revistas.unc.edu.ar/index.php/med/article/view/25882 Revista de la Facultad de Ciencias Médicas de Córdoba.; 2019: Suplemento JIC XX Revista de la Facultad de Ciencias Médicas de Córdoba; 2019: Suplemento JIC XX Revista da Faculdade de Ciências Médicas de Córdoba; 2019: Suplemento JIC XX 1853-0605 0014-6722 10.31053/1853.0605.v76.nSuplemento spa https://revistas.unc.edu.ar/index.php/med/article/view/25882/27705 Derechos de autor 2019 Universidad Nacional de Córdoba https://creativecommons.org/licenses/by-nc/4.0

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