Journal Article

DZNE-2026-00135

http://join2-wiki.gsi.de/foswiki/pub/Main/Artwork/join2_logo100x88.png Myocardial injury in patients with acute ischemic stroke: Prevalence and types of triggers of myocardial demand ischemia.

Stengl, H. (First author)DZNE* ; Böhme, S.Extern* ; Richter, O. ; Hellwig, S. ; Klammer, M. G. ; Ganeshan, R. ; Reimann, L.DZNE* ; Audebert, H. J. ; Doehner, W. ; Nolte, C. H. ; Endres, M.DZNE* ; Scheitz, J. F.

2026
Sage Publishing London

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Please use a persistent id in citations: doi:10.1093/esj/23969873251346008

Abstract: Acute myocardial injury occurs in about every fourth patient in the early phase after ischemic stroke. It may be caused by an imbalance between myocardial oxygen supply and demand, potentially leading to type 2 myocardial infarction (MI). However, little is known about the prevalence of potential triggers of such demand ischemia in acute stroke.Consecutive patients with and without post-stroke acute myocardial injury (elevated high-sensitivity cardiac troponin T [hs-cTnT] levels with a rise/fall >20%) were matched for age and sex and retrospectively screened for presence of predefined triggering conditions of myocardial demand ischemia and fulfillment of diagnostic criteria for acute MI.Among 508 stroke patients analyzed (median age 81 [73-86] years, 52% female), predefined potential triggers of demand ischemia were present in 107/254 (42%) patients with acute myocardial injury and in 61/254 (24%) matched controls (adjusted OR 2.30, 95%CI 1.51-3.52, p < 0.001). Patients with a trigger were older, more often female, had more severe strokes, and more often insular cortex involvement. The most prevalent triggers were respiratory failure, sustained hypertension, supraventricular tachyarrhythmia, and hemodynamic shock. MI criteria were fulfilled in 44/254 (17%) patients with acute myocardial injury including 27/44 (61.4%) with a trigger of demand ischemia (i.e. suspected type 2 MI).Conditions triggering a myocardial oxygen demand/supply mismatch are highly prevalent in patients with acute myocardial injury detected after stroke, notably in those fulfilling the criteria of acute MI. Stroke-specific aspects such as stroke severity or lesion location may play a role in the development of such triggers.

Keyword(s): Humans (MeSH) ; Female (MeSH) ; Male (MeSH) ; Aged (MeSH) ; Ischemic Stroke: complications (MeSH) ; Ischemic Stroke: epidemiology (MeSH) ; Prevalence (MeSH) ; Aged, 80 and over (MeSH) ; Retrospective Studies (MeSH) ; Myocardial Ischemia: epidemiology (MeSH) ; Myocardial Ischemia: etiology (MeSH) ; Troponin T: blood (MeSH) ; Myocardial Infarction: epidemiology (MeSH) ; Myocardial Infarction: etiology (MeSH) ; Stroke: complications (MeSH) ; Stroke: epidemiology (MeSH) ; 4th UDMI ; Ischemic stroke ; Stroke-Heart Syndrome ; acute myocardial injury ; central autonomic network% ; demand ischemia ; high-sensitivity cardiac troponin T ; type 2 MI ; Troponin T

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Contributing Institute(s):

1. Interdisciplinary Dementia Research (AG Endres)

Research Program(s):

1. 353 - Clinical and Health Care Research (POF4-353) (POF4-353)

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Database coverage:
; Clarivate Analytics Master Journal List ; Current Contents - Clinical Medicine ; Essential Science Indicators ; IF >= 5 ; JCR ; National-Konsortium ; PubMed Central ; SCOPUS ; Science Citation Index Expanded ; Web of Science Core Collection

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