The Risk Factors Of Troponin Ⅰ Increased After Acute Cerebral Infarction And Relationship With Electrocardiogram

Objective:This study aimed to investigate the incidence of elevated troponin I (cardiac Troponin I, cTnⅠ) in patients after acute cerebral infarction, risk factors and the relationship with ECG, and through the analysis of the relationship between cortisol and cTnⅠ to further explore its potential mechanism.Methods:In our prospective study,173patients with acute cerebral infarction were enrolled consecutively and ad-mitted to the Shanghai No.6People’s Hospital within24hours after symptoms onset between June2012and March2013. Investigate patients’previous medical history, record their basic situations on admission. All patients according to cTnl within24hours after symptoms onset whether elevated divided into high cTnl group and normal cTnl group. Record all patients’NIHSS score on admission, venous blood was drawn to determine the cTnl, myoglobin (MYO), creatine kinase isoenzyme (CKMB), blood routine, biochemical full set, BNP, C reactive protein (CRP), serum cortisol (8a.m.) and other indicators, ECG detection on admission; detect the cTnl concentration on the seventh day of patients in high cTnl group. Data were analyzed using statistical software SPSS17.0.Results:1. In our study of173patients with acute cerebral infarction, the incidence of cTnl increased is20.2%, the incidence of MYO、 CKMB increased is50.3%and17.3%.2. Compared with the patients in normal cTnl group, age、heart rate and NIHSS score on admission of patients in high cTnl group are significantly higher; proportion of diabetes、chronic renal insufficiency、atrial fibrillation history、history of stroke or TIA is higher too (P<0.05)3. Troponin I is not related to the infarction side. 4. Logistic regression analysis showed that age and NIHSS score on admission are independent associated with cTnⅠ in patients with acute cerebral infarction.5. White blood cell (WBC), blood urea nitrogen (BUN), fasting blood glucose (FBG), plasma B type natriuretic peptide (BNP), serum cortisol (S-cortisol) in high cTnⅠ group are significantly higher than that in normal cTnⅠ group (P<0.05); while hemoglobin (Hb), hematocrit (HCT), albumin (ALB) are lower than that in normal cTnl group (P<0.05).6. The incidence of ECG changes after cerebral infarction is39.9%in our study. Patients in high cTnⅠ group are more likely to have ECG changes than that in normal cTnⅠ group (P<0.001); and the ischemic electrocardiographic changes in patients with high cTnⅠ group was significantly higher than that in normal cTnl group (P<0.05), while other ECG changes are no difference in the two groups (P>0.05)7. On the seventh day after admission, in the high cTnl group,74.3%patients’ cTnl dropped to normal.8. On the first day after admission, cTnl was positively correlated with FBG (r=0.368, P<0.001), positive correlation with S-cortisol (r=0.266, P<0.001).Conclusion:1. The incidence rate of increased cTnⅠ after acute cerebral infarction is20.2%.2. Age and NIHSS score on admission are independent related to the cTnⅠ in patients with acute cerebral infarction.3. Patients in high cTnl group are more likely to have ECG changes than that in normal cTnⅠ group, and the ischemic electrocardiographic changes significantly increased.4. The stress reaction after acute cerebral infarction contributes to the cTnl increased.