Highly Sensitive Cardiac Troponin T Changes and Its Prognostic Value in Patients with Acute Stroke Nagwa M Doha 1* , Mostafa S Melake 2 , Ahmed M El-Kersh 3 , Mohammed H Badr 4 1 Department of Intensive Care and Pain Management, Menoufia University, Al Minufya, Egypt; 2 Department of Neurology, Menoufia University, Egypt; 3 Department of Cardiology, Menoufia University, Egypt; 4 Depratment of Critical Care Medicine, Menoufia University, Egypt ABSTRACT Background: The Acute ischemic stroke (AIS), which results in the corresponding loss of the neurological function, is characterized by sudden losses in the brain of blood circulation. Cardiac troponins (cTns) are used routinely for diagnosing acute myocardial infarction (AMI), but there is a complex overlap between cardiovascular and cerebrovascular disease. The aim of this study was to evaluate the incidence of Hs-cTnT elevation in acute ischemic stroke population and its prognostic significance. Patients and methods: We enrolled 161 patients admitted with acute ischemic stroke to Menoufia university hospitals and Assalam International hospital. We assessed the full medical history, neurological assessment, National Institutes of Health Stroke Scale (NIHSS), high-sensitive cardiac troponin T (hs-cTnT) level, and ECG on admission and after 24 hours. Statistical analysis was done using R-package for statistical analysis using the appropriate tests. Results: Our results revealed troponin in admission was elevated above >14 ng/dL in 58% of patients. Troponin dynamicity (delta troponin) defined as 25% increase in the admission value was found in 56% of patients. Analyzing ECG changes and echocardiographic findings revealed significant difference between delta troponin group and static troponin group regarding QTc prolongation (p=0.003), T wave changes (p=0.001), ST segment changes (p=0.013), and reduced ejection fraction (p=0.001). Poor outcome defined in our study as modified ranking scale ≥3 was found in 48.4% of patients, and good outcome found in 51.6% of patients. Conclusion: The acute Hs-cTnT elevation is high in acute ischemic stroke population, Hs-cTnT dynamicity within 24 hours is common, and delta troponin is correlated with stroke severity and poor outcome. Keywords: Hs-cTnT; Acute ischemic stroke; Delta troponin; Prognostic value; Static troponin INTRODUCTION Stroke is a sudden onset of brain injury with neuronal dysfunction/death caused by an acute focal injury and several pathophysiologic causes [1]. It was estimated that the incidence of strokes worldwide is 17 million annually. Therefore, stroke is considered as the third leading cause of reduced mobility in the world and the fifth leading cause of motility in the United States [2]. Strokes have two types: the most common one is ischemic (85%) and the rest being hemorrhagic type (15%) [3]. Acute ischemic stroke (AIS) is a serious condition characterized by sudden loss of blood supply, oxygen, nutrients, and elimination of metabolic wastes to an area of the brain, resulting in changes obstruct normal neuronal functioning [4]. It was classified into five subtypes according to TOAST trial: 1) Stroke of undetermined etiology, 2) Cardio-embolism, 3) Large artery atherosclerosis, 4) Small vessel occlusion, and 5) Stroke of other determined etiology [5]. Stroke survivors continue to be at higher risk of death, disability, and other serious complications, and it is of great clinical importance to predict outcome in acute stroke. Many biomarkers and clinical variables (such as advanced age and symptoms severity) are suggested as potential predictors J o u r n a l o f A n es t h e s i a & Cl i n i c a l R e s e a r c h ISSN: 2155-6148 Journal of Anesthesia & Clinical Research Research Article Correspondence to: Dr. Nagwa M Doha, Assistant Professor, Department of Intensive Care and Pain Management, Menoufia University, Al Minufya, Egypt, Tel: +201006235642; E-mail: nagwa.doha2020@gmail.com Received: January 28, 2020; Accepted: February 17, 2020; Published: February 24, 2020 Citation: Doha NM, Melake MS, El-Kersh AM, Badr MH (2020) Highly Sensitive Cardiac Troponin T Changes and Its Prognostic Value in Patients with Acute Stroke. J Anesth Clin Res. 11:936. DOI: 10.35248/2155-6148.20.11.936. Copyright: © 2020 Doha NM, et al. This is an open-access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited. J Anesth Clin Res, Vol.11 Iss.2 No:1000936 1