PS 17-58 ELEVATED TROPONIN I AND ECG GHANGES AFTER ACUTE HEMORRHAGIC STROKE IN PATIENTS WITH ARTERIAL HYPERTENSION

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Abstract

Objective:

To study features of (electrocardiogram) ECG changes and changes in cardiac biomarker troponin I in patients with acute hemorrhagic stroke (AHS) and arterial hypertension (AH).

Design and method:

We provide a retrospective analysis of 36 cases of patients with AH and AHS (19 males, aged 51,5 ± 4,7 years). In all patients the levels of fasting blood glucose, troponin I (TI) were determined, all patients underwent ECG. The presence and extent of AHS were performed using computed tomography of the brain. Stoke severity was assessed based on National Institutes of Health Stroke Scale (NIHSS). The presence and extent of coronary arteries occlusion were performed using coronary angiography.

Results:

Ischemic ECG changes was registered in 24 (66.6%) of 36 patients, they were characterized by diffuse repolarization disorders, there were negative type of T waves, positive-negative T waves in the standard and optional leads. TI was elevated in 28 (17.6%) of 36 patients. Patients with elevated TI were more likely to have higher age, higher blood glucose, elevated body temperature and ischemic ECG changes. There weren’t hemodynamically significant coronary occlusions in coronary angiography. TI levels were higher in patients with more severe stroke measured by NIHSS [0.38 (6.53–8.88) vs. 0.57 (10.25–17.86)]. There were 4 (11,1%) patients with elevated troponin in the presence of normal ECG. But a stroke conditioned an elevation of TI levels did not exceed the three standards.

Conclusions:

Ischemic ECG changes related with TI elevation in patients with AHS and AH occur frequently especially in patients with higher age, higher blood glucose, elevated body temperature and require differential diagnosis of acute myocardial infarction without elevation segment ST of the left ventricle. Stroke severity was associated with higher TI levels. Assessing the level of TI in the dynamics of treatment may be useful in these group of patients.

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