Cardiac involvement in patients with acute neurologic disease: Confirmation with cardiac troponin I

Sanjay Dixit, Martha Castle, Raja P. Velu, Lynn Swisher, Charles Hodge, Allan S Jaffe

Research output: Contribution to journalArticle

70 Citations (Scopus)

Abstract

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 (≥0.4 μg/L) in 17 patients (19%) (mean ± SD, 2.5 ± 2.7 μg/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 (≤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.

Original languageEnglish (US)
Pages (from-to)3153-3158
Number of pages6
JournalArchives of Internal Medicine
Volume160
Issue number20
StatePublished - Nov 13 2000

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Troponin I
Acute Disease
Nervous System Diseases
Nervous System
Wounds and Injuries
Mortality
Immunoassay
Electrocardiography
Odds Ratio
Incidence
Population

ASJC Scopus subject areas

  • Internal Medicine

Cite this

Cardiac involvement in patients with acute neurologic disease : Confirmation with cardiac troponin I. / Dixit, Sanjay; Castle, Martha; Velu, Raja P.; Swisher, Lynn; Hodge, Charles; Jaffe, Allan S.

In: Archives of Internal Medicine, Vol. 160, No. 20, 13.11.2000, p. 3153-3158.

Research output: Contribution to journalArticle

Dixit, S, Castle, M, Velu, RP, Swisher, L, Hodge, C & Jaffe, AS 2000, 'Cardiac involvement in patients with acute neurologic disease: Confirmation with cardiac troponin I', Archives of Internal Medicine, vol. 160, no. 20, pp. 3153-3158.
Dixit, Sanjay ; Castle, Martha ; Velu, Raja P. ; Swisher, Lynn ; Hodge, Charles ; Jaffe, Allan S. / Cardiac involvement in patients with acute neurologic disease : Confirmation with cardiac troponin I. In: Archives of Internal Medicine. 2000 ; Vol. 160, No. 20. pp. 3153-3158.
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