Title: Significance of Cardiac Enzymes in Patients with Acute Stroke

Authors: Dr P.Mohanapriya, Dr S.Sudharsan, Dr J.T.Sathishkumar

 DOI:  https://dx.doi.org/10.18535/jmscr/v5i10.95

Abstract

Stroke is a cerebrovascular event where in neurological deficit develops over minutes or hours, in a stepwise fashion, persists for twenty-four hours or more  and is because of a vascular disturbance which include arterial occlusion with consequent ischemic focal infarction of the brain. Various studies confirmed myocardial damage in stroke. So this  study was done to  assess the  cardiac damage  with  the usage of CK-MB, Trop –T  in  patients with acute stroke .Cardiac enzymes like creatine kinase (CK-MB) and Troponin-T   studied in these  patients showed that  CK-MB which was  specific for myocardial infarction loses its specificity in patients with stroke. CK-MB elevation in these patients does not indicate cardiac damage. Troponin –T was negative in most of the patients.

Keywords: stroke, cardiac damage, CK-MB, Trop-T.

References

  1. Levy A. The exiting cause of ventricular fibrillation in animals under chloroform anesthesia. Heart. 1913; 4: 319-78.
  2. Davis TP, Alexander J, Lesch M. Electrocardiographic changes Associated with acute cerebrovascular disease: a clinical review. Prog Cardiovasc Dis. 1993; 36: 245-60.
  3. Hasdai D, Haim M, Behar S, Boyako V, Battler A. Acute coronary syndromes in patients with prior cerebrovascular  events: lessons from the Euro-Heart Survey of Acute  Coronary syndromes. Am Heart J. 2003; 146: 832-8.
  4. Weidler DJ. Myocardial damage and cardiac arrhythymias after Intracranial   heamorrhage: A critical  review. Stroke.1974; 5: 759-764.
  5. Nayak SD, Nair M, Radhakrishnan K. Sarma PS. Ischemic stroke in the young adult: clinical features risk factors and outcome. Nat Med. J India1997;10:107-12.
  6. Lipska K, Sylaja PN, Sarma PS, Thangappan KR, Kutty VR, Vasan RS, et al. Risk factors for acute ischemic stroke in young adults in South India. J Neurol Neurosurg psychiatry 2007; 78; 959-963.
  7. Carolei A, Marinic, Ferranti E, Frontoni M, Prencipe M, et al 1993. A prospective study of cerebral ischemic in young; analysis of pathogenic determinants. The national research council study group stroke 24: 362-367.
  8. Kwon SU, Kim JS, Lee JH, Lee Mc (2000) Ischemic stroke in young adults. Acta Neurol Scand 101: 19-24.
  9. Varona JF, Guerra, JM, Bermej OF (2004) stroke in young adults. Med clin (Barc) 122: 70-74.
  10. Mehindratta MM, Agarwal P, Sen K, Sharma B, Stroke in young adults; A study from a Univesity hospital in North India. Med Sci Monit 2004; CR 535-541.
  11. Clinical profile of stroke in eastern Nepal; Kathmandu university medical jou. 2006.
  12. Bogarapu Kiranmayi M.D1, et al, (Department of Biochemistry, Siddhartha Medical College, Vijayawada, Andhra Pradesh, India) 2015 conducted a study on Evaluation of CK MB levels in Acute Ischemic stroke.
  13. Prognostic significance of admission levels of Troponin I in patients with acute ischemic stroke E Di Angelantonio, M. Fiorelli and et al J Neural Neurosurg Psychiatry 2005; 76: 76-81, doi: 10.1136/innp.2004.041491.
  14. Hakan Ay, MD; Ethem Murat Arsava, MD; Okay Saribas, MD Creatine Kinase – MB elevation after stroke is not cardiac in origin – Stroke 2002; 33: 286-289.
  15. Thomas P.Davis, Jay Alexander, Michael Lesch Electrocardiographic changes associated with acute cerebrovascular disease: A clinical review Progress in Cardiovascular Diseases – 1993 Nov-Dec; 36(3): 245-260.

Corresponding Author

Dr P.Mohanapriya

Post graduate, Department of General Medicine,

Rajah Muthiah Medical College and Hospital,

Annamalai University, Annamalai Nagar-608002