Comparison of troponin levels in isolated middle cerebral artery and anterior system tandem occlusion treated with mechanical thrombectomy

Abstract

INTRODUCTION: Ischemic stroke is the most common disability worldwide and the second most common cause of mortality. One of the major causes of mortality in patients with ischemic stroke is cardiac complications. However, high levels of troponin may be caused in patients with ischemic stroke and many of the systemic diseases that has a risk for the stroke. In this study, we aimed to investigate troponin levels of stroke patients who were treated with mechanical thrombectomy and the resulting risk factors for stroke, mortality and physical dependence at the end of the third month in tandem and M1 occlusions. METHODS: In this study, troponin values are examined retrospectively in stroke patients with tandem occlusion of the anterior circulation and middle cerebral artery M1 occlusions, who were treated between January 2015 and February 2019. SPSS Windows 23 package program was used in the statistical analysis of the data obtained from the study. Troponin values in tandem and middle cerebral artery occlusion were compared with chi-square method. Results were evaluated at 95% confidence interval and p<0.05 level of significance. RESULTS: When the mortality rates between tandem and MCA occlusions were examined at the end of the third month, mortality rates were higher in tandem occlusions and there was a statistically significant difference between the two groups (p: 0.027). There was no significant difference between tandem and MCA occlusions in terms of troponin values (p: 0.63). Patients with troponin values above 0.028 ng / mL had significantly higher mortality at 3 months. DISCUSSION and CONCLUSION: There is a relationship between mortality and elevation of troponin levels in patients who had tandem and MCA occlusions. However, there was no difference between tandem and MCA occlusions in terms of troponin values significantly. There is a need to further study the impact of ischemic stroke on troponin levels with randomized, controlled studies. MEKANİK TROMBEKTOMİ İLE TEDAVİ EDİLEN İZOLE ORTA SEREBRAL ARTER VE ÖN SİSTEM TANDEM OKLÜZYONU OLGULARINDAKİ TROPONİN DÜZEYLERİNİN KARŞILAŞTIRILMASIÖZET GİRİŞ ve AMAÇ: İskemik inme tüm dünyada en sık sakatlık bırakan ve ikinci sıklıkta mortaliteye neden olan hastalıktır. İskemik inme geçiren hastalarda mortalitenin önemli nedenlerinden biri de kardiyak komplikasyonlardır. Troponin, akut miyokard infarktüsünün tanısında ve akut koroner semptomları olan hastaların risk sıralamasında kullanılan yüksek duyarlılığı ve özgünlüğü olan bir belirteçtir. Bununla birlikte, iskemik inmeli hastalarda troponin yüksekliğine inme için ri sk oluşturan sistemik hastalıkların birçoğu neden olabilmektedir. Biz çalışmamızda mekanik trombektomi ile tedavi ettiğimiz tandem oklüzyonlar ve orta serebral arter M1 oklüzyonlarındaki troponin seviyelerini, inme risk faktörlerini, üçüncü ay sonundaki mortalite ve fiziksel bağımlılığı incelemeyi amaçladık. YÖNTEM ve GEREÇLER: Çalışmada Ocak 2015-Şubat 2019 yılları arasından hastanemize başvuran ve mekanik trombektomi ile tedavi edilen ön sistem tandem okl...