22. European Stroke Conference 618 Acute stroke: emergency management, stroke units and complications Troponin T in acute ischemic stroke: A prospective study. M. Kral1, D. Sanak2, T Veverka3, M. Hutyra4, D. Vindis5, A. Bartkova6, T. Dornak7, M. Svabova8, V. Kubickova9, J. Zapletalova10, R. Herzig11, P. Kanovsky12, D. Skoloudik13 Comprehensive Stroke Center, Department of Neurology, University Hospital and Faculty of Medicine and Dentistry, Palacký University, Olomouc, CZECH REPUBLIC1, Comprehensive Stroke Center, Department of Neurology, University Hospital and Faculty of Medicine and Dentist-ry, Palacký University, Olomouc, CZECH REPUBLIC2, Comprehensive Stroke Center, Department of Neurology, University Hospital and Faculty of Medicine and Dentistry, Palacký University, Olo-mouc, CZECH REPUBLIC3, Department of Internal Medicine I - Cardiology, University Hospital and Faculty of Medicine and Dentistry, Palacký University, Olomouc, CZECH REPUBLIC4, De-partment of Internal Medicine I - Cardiology, University Hospital and Faculty of Medicine and Den-tistry, Palacký University, Olomouc, CZECH REPUBLIC5, Comprehensive Stroke Center, Depart-ment of Neurology, University Hospital and Faculty of Medicine and Dentistry, Palacký University, Olomouc, CZECH REPUBLIC6, Comprehensive Stroke Center, Department of Neurology, Univer-sity Hospital and Faculty of Medicine and Dentistry, Palacký University, Olomouc, CZECH RE-PUBLIC7, Department of Clinical Biochemistry, University Hospital, Olomouc, CZECH REPUB-LIC8, Department of Clinical Biochemistry, University Hospital, Olomouc, CZECH REPUBLIC9, Department of Biophysics, Faculty of Medicine and Dentistry, Palacký University and Institute of Molecular and Translational Medicine, Olomouc, CZECH REPUBLIC10, Comprehensive Stroke Center, Department of Neurology, University Hospital and Faculty of Medicine and Dentistry, Palacký University, Olomouc, CZECH REPUBLIC11, Comprehensive Stroke Center, Department of Neurology, University Hospital and Faculty of Medicine and Dentistry, Palacký University, Olo-mouc, CZECH REPUBLIC12, Comprehensive Stroke Center, Department of Neurology, University Hospital and Faculty of Medicine and Dentistry, Palacký University, Olomouc, CZECH REPUB-LIC13 Background: Multiple interactions are considered to occur between the various forms of cardiovas-cular and cerebrovascular diseases. The aim of the study was to assess the serum level profile of cardiac troponin T (cTnT) in acute ischemic stroke (AIS) patients to evaluate factors associated with increased serum level of cTnT. Methods: AIS patients admitted within 12 h from stroke onset were enrolled in this prospective observational study. Neurological examination and brain computed to-mography or magnetic resonance imaging at admission, standard laboratory tests, including cTnT and other cardiac markers, at admission and 4 h later, and repeated electrocardiograms (ECGs) were performed in all patients. Correlations between cTnT and several baseline parameters were tested and multivariate regression analysis was used to assess the predictors of cTnT elevation. Results: In total, 107 consecutive AIS patients (65 males, mean age 67.2±14.2 years) were enrolled. 39 (36.4%) patients presented with elevated cTnT above the upper limit. The cTnT levels correlated significant-ly with age (r=0.448) and the levels of NT-proBNP (r=0.528), cystatin C (r=0.457), CK-MB mass (r=0.253), urea (r=0.281), and albumine (r=-0.219). Multiple logistic regression analysis found cre-atinine >90 μmol/L (OR=3.45; 95% CI: 1.09-10.85), NT-proBNP (OR=1.09 per 100 μg/L increase; 95% CI: 1.03-1.16) and CK-MB mass (OR=1.45 per 1 μg/L increase; 95% CI: 1.04-2.04) to be asso-ciated with cTnT elevation in AIS patients. Conclusion: Elevated cTnT can be relatively frequently detected in AIS patients. To reliably identify the patients with current acute myocardial impairment, more in-depth clinical investigation is needed. Trial registration information: ClinicalTrials.gov NCT01541163. Supported by the IGA MH CR grant number NT/11046-6/2010. 674 © 2013 S. Karger AG, Basel Scientific Programme 619 Acute stroke: emergency management, stroke units and complications The impact of pulmonary infections on the course and outcome of stroke S.T. Ristic1, D.T. Ristic2, I. Marinkovic3 Department of Neurology, University Clinical Centre Nis, Nis, SERBIA1, Institutae of Pulmo-nary Disaeses Nis, Nis, SERBIA2, Medical Faculty of Nis, Nis, SERBIA3 Background: Infection is the most common stroke complication. Occurance of acute bacterial lung infectuns affects the course of disease and outcome in stroke patients. Aim of the study was to ex-plore the frequency of hypostatic and aspiration pneumonia, their risk factor and their effect on out-come in patinets with acute stroke. Metods: In this prospective study we evaluated patients with stroke who were hospitalized at the Department of Neurology in Nis, between January-December 2012.There were a total of 1304 pa-tients with stroke. 852(65,34%) of 1304 patients with stroke had ischaemic stroke and 452(34,66%) had haemorrhagic stroke. Patients were evaluated and had the same investigations with anamnestic, clinical,neurological,biochemical analisys,physical examination by a specialist for pulmonary dis-eases, lung X-ray, Color-Doppler of the neck blood vessels, EEG and neuroimaging (CT of lung,CT of brain,MRI of brain,MRA angiography) variables which were compared. Results: Of a total of 1304 patients with stroke, 62 patients (4,75%) of them had pulmonary compli-cations within 10 day from the event. There were 37 male and 25 female patients, age from 41 to 87 years. Pulmonary infections in all of the patients was confirmed by x-ray imaging and biochemical analisys. 32(51,61%) patients had lobar pneumonia, 19(30,64%) had bilateral bronchopneumonic changes and 11(17,74%) had pleural effusion. All of the patients were higly febrile, with increased sedimentation and leucocitosys with dominant neutrophiles. Despite the intensive antibiotic treat-ment, using two or more antibiotics in combination,14 patients has died. Conclusion: Hypostatic and aspiration pneumonia are frequent complications of stroke associated with poor outcome. Regading to this fact, an intensive prevention of complications is necessary im-mediately after hospitalization. Keywords: Pulmonary infection, Stroke, Survival of patients with stroke, Neurological disease, Pneumonia
Karger_ESC London_2013
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