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

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