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Open Access Highly Accessed Research article

Cardiac Troponin I elevation after epileptic seizure

Nicole Sieweke1, Jens Allendörfer16, Wolfgang Franzen2, Andreas Feustel3, Frank Reichenberger4, Wolfgang Pabst5, Heidrun Heidi Krämer1, Manfred Kaps1 and Christian Tanislav17*

Author Affiliations

1 Departments of Neurology, Justus Liebig University Giessen, Giessen, Germany

2 Departments of Cardiology, Justus Liebig University Giessen, Giessen, Germany

3 Departments of Nephrology, Justus Liebig University Giessen, Giessen, Germany

4 Departments of Respiratory Medicine, Justus Liebig University Giessen, Giessen, Germany

5 Departments of Institute for Biomedicine and Epidemiology, Justus Liebig University Giessen, Giessen, Germany

6 Department of Neurology, Neurologische Klinik Bad Salzhausen, Justus Liebig University Giessen, Giessen, Germany

7 Department of Neurology, Justus Liebig University, Giessen, Klinikstrasse 33, 35385, Giessen, Germany

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BMC Neurology 2012, 12:58  doi:10.1186/1471-2377-12-58

Published: 17 July 2012

Abstract

Background

Cardiac troponin-I (cTNI) is highly specific biomarker to prove myocardial damage, e.g. in acute coronary syndrome (ACS). However, it occurs in other conditions as well. We therefore analysed cTNI increase in patients after generalized convulsive seizure.

Methods

Consecutive patients admitted with acute generalized convulsive seizure were included in case of cTNI measurement on admission. Among 898 selected cases, 53 patients were referred secondary to our department; in 845 cases cTNI measurements on admission were available. In case of multiple admissions (81 cases), only the first admission entered our analysis. In 17 patients elevated cTNI was determined due to ACS; in one patient a myocarditis was found. 5 patients suffered of relevant renal insufficiency. Finally 741 patients were included in the analysis. A cTNI cut-off level of ≥ 0.1 ng/ml was considered. Factors associated with a cTNI increase were analysed subsequently.

Results

The mean age of the study population (n = 741) was 47.8 years (SD ± 18.6), 40.9% were female. In 50 patients (6.7%) a cTNI elevation of unknown origin was found; no obvious cardiac involvement could be detected in these patients who all remained asymptomatic. A vascular risk profile (including at least hypertension, hypercholesterolemia or diabetes) (OR = 3.62; CI: 1.59 to 8.21; p = 0.001) and elevated creatine kinase on admission (OR = 2.36; CI: 1.26 to 4.39; p = 0.002) were independent factors associated with cTNI release.

Conclusion

cTNI release occurs in patients with generalized convulsive seizure with predominance in patients with vascular risk profile.

Keywords:
Seizure; Vascular risk profile; Epilepsy; Coronary syndrome; Cardiac troponin