Positive Troponin Level and Association with Electrocardiogram Findings Among Kurdish Patients with Acute Ischemic Stroke

Abstract

Background: Cardiac troponins T and I are specific myocardial injury markers associated with acute ischemic stroke. Several mechanisms have been proposed as the possible cause of myocardial damage in stroke patients. ECG abnormalities caused by acute stroke are still unknown. Objectives: The present study evaluated troponin’s level and compliance with electrocardiogram findings among Kurdish patients with acute ischemic stroke. Methods: Positive troponin was investigated among all patients diagnosed with acute ischemic stroke admitted to Imam Reza Hospital in Kermanshah from 21 March 2018 to 20 March 2019. Comprehensive electrocardiography examinations were performed and interpreted by a cardiologist and a neurologist. The presence of Q wave, T wave inversion, and ST-segment elevation or depression as evidence of coexisting cardiac ischemia were compared between patients with positive and a randomly selected group of patients with negative troponin. Results: A total of 13.2% of participants (n = 21) had atrial fibrillation (AF). One patient with positive troponin and 13.4% (n = 20) of patients with negative troponin had AF in their ECGs (P = 0.67). The frequency of other disorders, including T wave inversion, left branch bundle block, ST-segment elevation, and the presence of pathological Q wave, was 6.3% (n = 10), 5.7% (n = 9), 5% (n = 8), and 5% (n = 5), respectively. The results showed no significant relationship between positive (increase) or negative troponin with electrocardiogram abnormalities (P > 0.05). Conclusions: Since routine ECGs are obtained from all acute stroke patients, routine troponin measurements may not be necessary for all patients or may be limited to those with electrocardiographic abnormalities.