Troponin Elevation in Acute Ischemic Stroke (TRELAS)

The primary objective of the prospective observational trial TRELAS (TRoponin ELevation in Acute ischemic Stroke) is to elucidate the underlying pathomechanism of cTnT elevation in acute ischemic stroke in order to give guidance for clinical practise. All consecutive patients with acute MRI- or CT-confirmed ischemic stroke admitting within 72 hours after symptom onset to the Department of Neurology Campus Benjamin Franklin of the university hospital of the Charité will be screened for cTnT elevations suggestive of myocardial infarction (>0,05 µg/l) on admission and day 2. Patients with increased troponin will undergo diagnostic coronary angiography within 72 hours. Diagnostic findings of coronary angiographies taken out in age- and gender-matched patients presenting with NSTE-ACS (Non-ST-Elevation Acute Coronary Syndrome) to the Division of Cardiology will serve as a control. The primary endpoint of the study will be the occurrence of angiographic culprit lesions indicating focal cardiac damage on the basis of an acute CAD. Secondary endpoints will be the localisation of stroke in the cerebral imaging and ventriculographic findings of wall motion abnormalities suggestive of neurally mediated global cardiac dysfunction.

Inclusion criteria

• Acute ischemic stroke, confirmed by cerebral MRI or CT, respectively
• Inclusion within ≤ 72 hours after symptom onset
• hsTroponin T >0,05 µg/l

Exclusion criteria

• Renal insufficiency (creatinine ≥1,2 mg/dl)
• Limited life expectancy or mRS ≥ 4 prior to stroke event leading to hospital admission
• Contraindications for the coronary angiography
• Age < 18 years
• Pregnancy
• Patient unwilling or unable to give informed consent