Acute Exacerbation of COPD Is Associated With Fourfold Elevation of Cardiac Troponin T

Study Questions:

What is the association between an acute exacerbation of chronic obstructive pulmonary disease (AECOPD) and myocardial injury determined by high-sensitivity cardiac troponin T (hs-cTnT)?

Methods:

This was a cross-sectional study with an index group of patients hospitalized for AECOPD at a teaching hospital compared to a reference group recruited at a lung rehabilitation hospital in a stable state. The detection limit for hs-cTnT was 3.0 ng/ml. The main outcome was the ratio of hs-cTnT in hospitalized AECOPD patients compared with stable COPD patients.

Results:

After inclusion of all relevant covariables, multiple linear regression analyses showed that the ratio between hs-cTnT in AECOPD patients and the references was 4.26 (95% confidence interval, 3.02-6.00). None of the patients were diagnosed with myocardial infarction at discharge from the hospital.

Conclusions:

The authors concluded that compared with stable COPD, AECOPD is associated with higher hs-cTnT.

Perspective:

In a cross-sectional study, the authors demonstrated that AECOPD, when compared to stable COPD, is associated with higher levels of hs-cTnT. Given the cross-sectional design, the higher levels of hs-cTnT cannot be interpreted causally. The precise significance of the findings from this study is uncertain and should be examined with caution, until the determinants for troponin elevation during AECOPD are better understood or elucidated.

Keywords: Hospitals, Myocardial Infarction, Cytoskeletal Proteins, Biological Markers, Heart Injuries, Cross-Sectional Studies, Cardiology, Cardiovascular Diseases, Troponin, Lung Diseases


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