Troponin Elevation in Acute Ischemic Stroke (TRELAS)

Study Overview
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Brief Summary
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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. Consecutive patients with acute ischemic stroke admitted to the Department of Neurology Campus Benjamin Franklin of the university hospital Charité will be screened for cTnT elevations suggestive of myocardial infarction (>0,05 µg/l). 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 culprit lesions indicating focal cardiac damage on the basis of an acute CAD.

Detailed Description
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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.

Official Title
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Troponin Elevation in Acute Ischemic Stroke (TRELAS) - a Prospective Study on the Frequency and Correlation to Coronary Artery Disease and to Stroke Localisation

Conditions
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Stroke

Intervention / Treatment
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* Procedure: coronary angiogram


Participation Criteria
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Eligibility Criteria
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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

Ages Eligible for Study
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Minimum Age: 18 Years

Sexes Eligible for Study
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All

Accepts Healthy Volunteers
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No

Study Plan
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How is the study designed?
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Arms and Interventions

| Participant Group/Arm | Intervention/Treatment |
| --- | --- |
| stroke, troponin elevation<br>Patients with stroke (proven by cerebral imaging) and troponin elevation undergoing coronary angiogram | Procedure: coronary angiogram<br>* coronary angiogram<br>|
| non-stemi (controll group)<br>Patients with troponin elevation suggesting non-stemi undergoing coronary angiogram | Procedure: coronary angiogram<br>* coronary angiogram<br>|

What is the study measuring?
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Primary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| culprit lesion on coronary angiogram |  | 24 months | 

Secondary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| transient apical ballooning on levocardiogram |  | 24 months | 
| stroke localization |  | 24 months | 

 Terms related to the study
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Keywords Provided by Centre Hospitalier Valida
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ischemic stroke, troponin elevation, transient apical ballooning, acute coronary syndrome, troponin elevation,, culprit lesion on coronary angiogram,, troponin elevation and stroke localisation (temporal lobe?)