Serum Levels of Cardiac Troponin I in Patients with Uncomplicated Epileptic Seizure

Background: Cardiac troponin I (cTnI) is a myofibrillar protein regulating the interaction of actin and myosin. It is 100% tissue specific for the heart and is an excellent serum marker for detecting myocardial injury. Based on previous studies, contradictory results have been reported about elevation of serum levels of cTnI in patients presenting with subacute or acute neurological disorders with or without seizures. Here we assess serum levels of cTnI in patients following uncomplicated epileptic seizures and with a healthy cardiovascular system.

Methods: In this analytical cross-sectional study, 49 patients (age range: 12-65 years) with uncomplicated epileptic seizure and no history of cardiac problems were included. cTnI level was evaluated in patients between 6 h and 10 days after a seizure. Electrocardiography and echocardiography were also performed. Variables including number of seizures, age at first seizure, and time elapsed from the last seizure, in addition to demographic variables, were also evaluated.

Results: Average age of patients was 21.18 years (standard deviation [SD] +/-8.37) with a male/female ratio of 2.26. Mean elapsed time from the last seizure was 54 h (SD +/-52.97). cTnI level was within the normal range (<0.1 ng/mL) in all patients with a mean level of 0.026 ng/mL (SD +/-0.015). A significant statistical correlation was found between serum level of cTnI and number of epileptic seizures (Spearman r = 0.743, p <0.001).

Conclusions: Serum level of cTnI following seizure was within normal limits in 12 to 65-year-old patients with uncomplicated epileptic seizures and healthy cardiovascular system. However, this level was higher in patients with more than three repeated seizures. Repeated measurement of level of cTnI up to several days after presence of a seizure may be helpful in further assessment of this relationship.