الفهرس 
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Abstract
Acute ischemic stroke (AIS) is characterized by the sudden loss of blood circulation to an area of the brain, resulting in a corresponding loss of neurologic function. Strokes can be divided into 2 types: hemorrhagic or ischemic. Acute ischemic stroke is caused by thrombotic or embolic occlusion of a cerebral artery .
Stroke is the third most prevalent cause of death after heart disease and cancer, and is the leading cause of long-term disability (2).
Various biomarkers have been suggested to predict outcome in ischemic stroke.
Cardiac troponins (cTns) are used routinely for diagnosing acute myocardial infarction (AMI), but There is a complex overlap between cardiovascular and cerebrovascular disease . Cardiac troponins (cTns) reported to be positive in up to 34 % of patients with acute ischemic stroke .
The cause of troponin rise in acute stroke is not clear. In some patients, raised troponin could reflect an association of coronary artery disease and acute stroke. However, it has also been suggested that some of the myocardial damage observed in acute stroke is due to patchy myocyte damage (myocytolysis) due to activation of the sympathoadrenal system that may be linked to insular damage .
Cardiac troponins (cTns) have also been investigated as prognostic markers in the setting of ischemic stroke with diverging results. Some studies have reported an association between elevated levels of cardiac troponin T (cTnT) and cardiac troponin I (cTnI) and poor outcome in acute stroke, while other studies have failed to find an independent association.
A new generation of highly sensitive troponin assays have been developed that allow for the detection of concentrations 5 to 10 times lower than those measureable with conventional assays. In patients with stable coronary heart disease, cTnT measured with a highly sensitive assay at levels below the limit of detection of conventional assays was associated with increased mortality. However, the prognostic value of hscTnT in the setting of acute ischemic stroke (AIS) remains to be determined. We investigated the asociaition between Hs-cTnT and Poor outcome
The aim of this study was to evaluate the incidence of Hs-cTnT elevation in acute ischemic stroke population and it’s prognositic significance
We enrolled 161 patients admitted with acute ischemic stroke to Menoufia university hospitals and Assalam International hospital , medical history and full neurological assessment and NIHSS, hs-cTnT level , ECG done on admission and after 24 hours hs-cTnT level , ECG and TTE done
Patients were followed for 30 days and the following date were collected : MRS score after 30 days , ICU admission , NGT insertion ,need of mechanical ventilation , development of bedsores
Statistical analysis done using R- package for statistical analysis using the appropriate tests
Our results revealed Troponin in admission was elevated above > 14 ng/dl in 58 % of patients
Troponin dynamicity ( delta troponin) defined as 25 % increase in the admission value was found in 56 % of patients
Patient int the delta troponin group had statistically significant difference regarding Age , history of hypertension , Smoking , dyslipidemia and NIHSS on admission , heart rate on admission