The presence of an elevated serum troponin in a patient with an acute stroke has prognostic significance.
Causes for an elevated troponin in a patient with acute stroke:
(1) new onset of atrial fibrillation
(2) acute myocardial infarction triggered by the stroke
(3) acute myocardial infarction preceding the stroke
Further testing may include:
(1) brain natriuretic peptide (BNP)
(2) echocardiography which may disclose a new segmental wall motion abnormality
(3) 24-hour Holter monitoring
Coronary artery disease is associated with:
(1) elevated serum troponin concentration
(2) elevated brain natriuretic peptide (BNP)
(3) segmental wall motion abnormalities on echocardiography
(4) decreased left ventricular ejection fraction
Prognostic significance:
(1) higher risk of myocardial infarction, stroke or death within 3 months
(2) worse prognosis
