High-Sensitivity Cardiac Troponin T Levels Are Increased in Stable COPD

Study Questions:

What is the distribution of high-sensitivity cardiac troponin T (hs-cTnT) concentrations in patients with stable chronic obstructive pulmonary disease (COPD), compared to patients from the general population, and what is the association between pulmonary function and hs-cTnT among patients with stable COPD?

Methods:

This was a prospectively designed, cross-sectional study. The participants were 101 stable COPD patients from the outpatient clinic of a Norwegian teaching hospital and 120 individuals derived from a random general population sample. The ratio of hs-cTnT in stable COPD patients was compared with references from the general population. Patients with a history of congestive heart failure or coronary artery disease were excluded.

Results:

In the final multivariable model, the ratio of hs-cTnT between cases and references was 1.65 (1.31-2.08, p < 0.001). In the analysis restricted to the COPD patients, there was a significant association between hs-cTnT and the severity of disease. In the total study cohort, as well as among stable COPD patients, there was a significant positive association between hs-cTnT and interleukin-6 (IL-6) concentrations (p < 0.001) and the presence of pathologic Q waves (p = 0.023).

Conclusions:

Compared to a reference sample drawn from the general Norwegian population, Norwegian patients with stable COPD presumably free of cardiovascular disease have higher circulating levels of TnT.

Perspective:

It was recently demonstrated that an acute exacerbation of COPD is associated with higher hs-cTnT levels, when compared to stable COPD, among patients recruited from a rehabilitation hospital. This study, while limited in its ability to draw any causative inferences because of its cross-sectional design, adds to those results by reporting on the distribution of hs-cTnT in patients with stable COPD. The association between higher hs-cTnT levels and higher IL-6 concentrations and pathological Q waves may indicate that inflammatory activity and/or unrecognized myocardial infarction may contribute to higher hs-cTnT concentrations in stable COPD. Further exploration of the current results is justified to better understand the low-grade myocardial damage that seems to exist among stable COPD patients.

Keywords: Pulmonary Disease, Chronic Obstructive, Biological Markers, Interleukin-6, Troponin T


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