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@ARTICLE{Stengl:285001,
author = {Stengl, Helena and Böhme, Sophie and Richter, Oskar and
Hellwig, Simon and Klammer, Markus G and Ganeshan, Ramanan
and Reimann, Laura and Audebert, Heinrich J and Doehner,
Wolfram and Nolte, Christian H and Endres, Matthias and
Scheitz, Jan F},
title = {{M}yocardial injury in patients with acute ischemic stroke:
{P}revalence and types of triggers of myocardial demand
ischemia.},
journal = {European stroke journal},
volume = {11},
number = {1},
issn = {2396-9873},
address = {London},
publisher = {Sage Publishing},
reportid = {DZNE-2026-00135},
pages = {23969873251346008},
year = {2026},
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.},
keywords = {Humans / Female / Male / Aged / Ischemic Stroke:
complications / Ischemic Stroke: epidemiology / Prevalence /
Aged, 80 and over / Retrospective Studies / Myocardial
Ischemia: epidemiology / Myocardial Ischemia: etiology /
Troponin T: blood / Myocardial Infarction: epidemiology /
Myocardial Infarction: etiology / Stroke: complications /
Stroke: epidemiology / 4th UDMI (Other) / Ischemic stroke
(Other) / Stroke-Heart Syndrome (Other) / acute myocardial
injury (Other) / central autonomic $network\%$ (Other) /
demand ischemia (Other) / high-sensitivity cardiac troponin
T (Other) / type 2 MI (Other) / Troponin T (NLM Chemicals)},
cin = {AG Endres},
ddc = {610},
cid = {I:(DE-2719)1811005},
pnm = {353 - Clinical and Health Care Research (POF4-353)},
pid = {G:(DE-HGF)POF4-353},
typ = {PUB:(DE-HGF)16},
pubmed = {pmid:41614487},
doi = {10.1093/esj/23969873251346008},
url = {https://pub.dzne.de/record/285001},
}