Using creatine kinase, creatine kinase-mb, troponin i, d-dimer values in diagnosing patients with ischemic stroke in emergency service

Stroke is the third reason of the deaths after heart diseases and cancer and it is the kind of disease leaving disability. By early diagnose and treatment of the patients who came to the emergency service, the impact of this disease is reduced on the mortality and morbidity. There may be an increase in D-Dimer and cardiac markers in the ischemic stroke and this increase has a relation with a bad prognosis. The patient who were diagnosed with the ischemic stroke between the dates October 2006 - March 2007 were taken into this study. In these patients when they first applied and in 3rd day, in the blood D-Dimer, creatine kinase-myocardial band, Troponin-I, myoglobin where studied and the relation between Glasgow Coma Score and mortality was studied. 100 patients, of whom 53% where male and 47% famale were taken into this study. 59% of the patients hypertension, 42% atherosclerosis, 33% ischemic cardiac disease, 21% diabetes mellitus, 20% atrial fibrillation, 6% cerebrovascular diseases, 4% had a history of temporary attack. 34 of the patients eksitus. The D-Dimer, creatine kinase-myocardial band, Troponin-I, myoglobin, Glasgow Coma Score values of the patients who died and those who where discharged were compared. D-Dimer was 2510.21±327.16 ng/ml in the mortality group and 1283.85±174.23 ng/ml in the discharged group and when compared, there was a statistical meaning (p<0.05). When Tropinin-I was compared, there was no statistical differance in mortality (p>0.05). Glasgow Coma Score was 10.64±3.61 in the mortality group and 13.80±1.91 in the discharged group and there was statistical meaning between them (p<0.05). When the mortality group and the discharged group were compared, we found out that the myoglobin values, the creatine cinase-myocardial band and D-Dimer with high values and Glasgow Coma Score with a low value increased the rate of the mortality. When this results were taken into consideration with the previous studies, we can suggest that D-Dimer, myoglobin and the lower levels of GKS are assessed as the indicator of mortality and malign prognosis. Yet, we believe that we need more studies on this subject.