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Neth J Med. 2009 Nov;67(10):341-9.

Prognostic value of cardiac troponin I in patients with COPD acute exacerbation.

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1
Department of Medicine, Hospital Sao Joao, Porto, Portugal. Carlamrt@nortemedico.pt

Abstract

BACKGROUND:

Chronic obstructive pulmonary disease (COPD) is frequently associated with right ventricular loading and pulmonary hypertension. We aimed to evaluate a possible association between cardiac troponin I (cTnI) levels and adverse events in hospitalised patients with acute exacerbation of COPD .

METHODS:

Retrospective cohort study, with analysis of admissions for acute exacerbation of COPD , with cTnI obtained in the first 48 hours of admission. A positive cTnI test was defined as 0.012 ng/ml or higher (99th percentile). Baseline and peak troponin I levels were taken as independent variables, and outcome variables included length of hospital stay, complications during hospitalisation, and in-hospital and extra-hospital mortality (evaluated 18 months post-discharge).

RESULTS:

Data concerned 173 patients (105 male, 68 female), with a median age of 77 years (interquartile range of 11 years). The median baseline cTnI was 0.030 ng/ml (n=173), and the median peak cTnI was 0.040 ng/ml (n=173; absolute peak value of 1.260 ng/ml). Nearly 70% of cases had a positive cTnI at admission. Both baseline and peak cTnI correlated significantly with the need for noninvasive ventilatory support. We were not able to find significant differences in in-hospital survival associated with the two troponin groups, but overall 18-month survival was significantly higher among patients with lower values of baseline and peak cTnI.

CONCLUSIONS:

In patients hospitalised for acute COPD exacerbations, elevated baseline and peak cTnI were associated with a greater need for noninvasive ventilatory support and were significant predictors of 18-month overall survival.

PMID:
19915228
[Indexed for MEDLINE]
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