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