심근효소 수치의 뇌졸중의 예후 예측에서의 효용성
The Usefulness of Cardiac Biomarker in Patients with Acute Ischemic Stroke
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Background: Cardiac enzymes such as creatine kinase-MB, troponin I, and brain natriuretic peptide (BNP) are thought to be useful prognostic factors in patients with acute ischemic stroke. This study investigated the efficacy of cardiac biomarkers as prognostic factors. Methods: We reviewed patients with acute ischemic stroke whose cardiac biomarkers had been measured and who were admitted to our hospital between January 2012 and December 2013. The cardiac biomarkers were measured within 24 hours after admission to the emergency room. We evaluated the clinical characteristics and compared the outcomes of the patients based on their cardiac biomarkers. Results: The following cardiac biomarkers were measured in 219 patients with acute ischemic stroke: creatine kinase-MB (n=218), troponin I (n=219), and BNP (n=143). Statistically significant differences were observed in older age (68.77±12.42 vs. 74.59±6.68, p<0.05), insula involvement (30.5% vs. 59.1%, p<0.01), and higher BNP (259.75±422.65 vs. 667.06±1093.22, p<0.01). Conclusions: These results suggest that measuring all cardiac biomarkers may be not effective in determining the prognosis of acute ischemic stroke. However, BNP may be a superior to troponin I in predicting the prognosis.
Abstract
Background: Cardiac enzymes such as creatine kinase-MB, troponin I, and brain natriuretic peptide (BNP) are thought to be useful prognostic factors in patients with acute ischemic stroke. This study investigated the efficacy of cardiac biomarkers as prognostic factors. Methods: We reviewed patients with acute ischemic stroke whose cardiac biomarkers had been measured and who were admitted to our hospital between January 2012 and December 2013. The cardiac biomarkers were measured within 24 hours after admission to the emergency room. We evaluated the clinical characteristics and compared the outcomes of the patients based on their cardiac biomarkers. Results: The following cardiac biomarkers were measured in 219 patients with acute ischemic stroke: creatine kinase-MB (n=218), troponin I (n=219), and BNP (n=143). Statistically significant differences were observed in older age (68.77±12.42 vs. 74.59±6.68, p<0.05), insula involvement (30.5% vs. 59.1%, p<0.01), and higher BNP (259.75±422.65 vs. 667.06±1093.22, p<0.01). Conclusions: These results suggest that measuring all cardiac biomarkers may be not effective in determining the prognosis of acute ischemic stroke. However, BNP may be a superior to troponin I in predicting the prognosis.
참고문헌 (19)
- Jauch EC, "Guidelines for the early management of patients with acute ischemic stroke: a guideline for healthcare professionals from the American Heart Association", American Stroke Association, 2013, pp.44, 870~947
- Myers MG, "Cardiac sequelae of acute stroke", Stroke, 13, pp.838~842 (1982)
- Agewall S, "Troponin elevation in coronary vs. non-coronary disease", Eur Heart J, 32, pp.404~411 (2011)
- Norris JW, "Serum cardiac enzymes in stroke", Stroke, 10, pp.548~553 (1979)
- Di Angelantonio E, "Prognostic significance of admission levels of troponin I in patients with acute ischaemic stroke", J Neurol Neurosurg Psychiatry, 76, pp.76~81 (2005)
- Apak I, "Serum cardiac troponin T levels as an indicator of myocardial injury in ischemic and hemorrhagic stroke patients", Tohoku J Exp Med, 205, pp.93~101 (2005)
- James P, "Relation between troponin T concentration and mortality in patients presenting with an acute stroke: observational study", BMJ, 320, pp.1502~1504 (2000)
- Jensen JK, "Frequency and significance of troponin T elevation in acute ischemic stroke", Am J Cardiol, 99, pp.108~112 (2007)
- Ay H, "Creatine kinase-MB elevation after stroke is not cardiac in origin: comparison with troponin T levels", Stroke, 33, pp.286~289 (2002)
- 김욱주, "급성기 뇌경색환자의 내원시 Troponin-I 수치와 예후와의 연관성", 대한뇌졸중학회지, 5(1), pp.59~63 (2003), 대한뇌졸중학회
- Darki A, "Correlation of elevated troponin and echocardiography in acute ischemic stroke", J Stroke Cerebrovascr Dis, 22, pp.959~961 (2013)
- Hasirci B, "Elevated troponin level with negative outcome was found in ischemic stroke", Cardiovasc Psychiatry Neurol, 2013, pp.953672~ (2013)
- Maruyama K, "Brain natriuretic peptide in acute ischemic stroke", J Stroke Cerebrovasc Dis, 23, pp.967~972 (2014)
- Iltumur K, "Elevated plasma N-terminal pro-brain natriuretic peptide levels in acute ischemic stroke", Am Heart J, 151, pp.1115~1122 (2006)
- Etgen T, "Cardiac troponins and N-terminal pro-brain natriuretic peptide in acute ischemic stroke do not relate to clinical prognosis", Stroke, 36, pp.270~275 (2005)
- The writing group of clinical practice guideline for stroke, "Clinical Practice Guidelines for Stroke" (2013), Clinical Research Center For Stroke
- Cechetto DF, "Autonomic and myocardial changes in middle cerebral artery occlusion:stroke models in the rat", Brain Res, 502, pp.296~305 (1989)
- Tokgozoglu SL, "Effects of stroke localization on cardiac autonomic balance and sudden death", Stroke, 30, pp.1307~1311 (1999)
- Nakagawa K, "Plasma concentrations of brain natriuretic peptide in patients with acute ischemic stroke", Cerebrovasc Dis, 19, pp.157~164 (2005)