Document Detail

Cardiac involvement in patients with acute neurologic disease: confirmation with cardiac troponin I.
MedLine Citation:
PMID:  11074746     Owner:  NLM     Status:  MEDLINE    
BACKGROUND: Patients with acute neurologic illness often manifest findings suggestive of cardiac injury. Their proper interpretation is unclear. Accordingly, we conducted a blinded evaluation to assess the incidence of cardiac injury determined by elevations of cardiac troponin I (cTnI) in patients presenting within 24 hours of a neurologic event and to determine their short- and long-term prognostic effect. METHODS: Blood samples for measurement of cTnI levels were obtained on hospital admission and daily for 3 days and were run by immunoassay. Extensive clinical evaluations including electrocardiograms and echocardiograms were obtained from all patients; daily follow-up evaluations were performed. The clinical electrocardiographic, echocardiographic, and biochemical data were analyzed independently by blinded observers. RESULTS: Peak levels of cTnI were elevated (> or =0.4 microg/L) in 17 patients (19%) (mean + SD, 2.5 + 2.7 microg/L). All patients with elevated cTnI levels had clinical, electrocardiographic, or echocardiographic evidence of cardiac injury except those (n = 5) with minor elevations. One-year mortality was 29% (23/80). Early death (< or =30 days) accounted for 44% of total mortality (n = 10) and was significantly higher in patients with elevated cTnI levels (Wilcoxon P =.01; odds ratio, 6. 4). This difference was less marked by 1 year (Wilcoxon P =.07). CONCLUSIONS: There is a substantial prevalence of myocardial injury in patients with acute neurologic illness. Cardiac injury in this population, as in others, seems to adversely affect prognosis.
S Dixit; M Castle; R P Velu; L Swisher; C Hodge; A S Jaffe
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Publication Detail:
Type:  Journal Article; Research Support, Non-U.S. Gov't    
Journal Detail:
Title:  Archives of internal medicine     Volume:  160     ISSN:  0003-9926     ISO Abbreviation:  Arch. Intern. Med.     Publication Date:  2000 Nov 
Date Detail:
Created Date:  2000-12-27     Completed Date:  2000-12-27     Revised Date:  2006-11-15    
Medline Journal Info:
Nlm Unique ID:  0372440     Medline TA:  Arch Intern Med     Country:  UNITED STATES    
Other Details:
Languages:  eng     Pagination:  3153-8     Citation Subset:  AIM; IM    
Mayo Clinic, 200 First St SW, Mayo Clinic Building, 16th Floor, Rochester, MN 55905, USA.
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MeSH Terms
Acute Disease
Heart Diseases / blood*,  epidemiology,  etiology*
Middle Aged
Nervous System Diseases / blood*,  complications*
Survival Rate
Time Factors
Troponin I / blood*
Reg. No./Substance:
0/Troponin I

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine

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