Cardiac troponin I in patients with severe exacerbation of chronic obstructive pulmonary disease.
OBJECTIVE
Co-morbid conditions including risk factors for cardiovascular diseases and left ventricular dysfunction are common in patients with chronic obstructive pulmonary disease (COPD). This study assessed the incidence of cardiac troponin I (cTnI) elevation, a specific marker for cardiac injury, and its prognostic significance during severe exacerbation of COPD.


METHODS
Prospective cohort study.


METHODS
Two intensive care units.


METHODS
Seventy-one consecutive patients admitted for severe exacerbation of COPD.


METHODS
None.


RESULTS
Cardiac troponin I was assayed in blood samples obtained on admission and 24 h later (Stratus II immunoassay analyser, Dade International). Levels above 0.5 ng/ml were considered positive. The following data were recorded prospectively: clinical symptoms, co-morbidities, cause of the exacerbation, diagnostic procedures and treatment, general severity score (SAPS II) and in-hospital outcome. CTnI was positive in 18% of patients (95% confidence interval (CI(95)), 11-29%), with a median value at 1.00 ng/ml; CI(95 )(0.60-1.70). Eighteen patients died in the hospital (25%; CI(95), 17-37%). Only cTnI (adjusted odds ratio (ORa), 6.52; CI(95),1.23-34.47) and SAPS II 24 h after admission (ORa, 1.07; CI(95), 1.01-1.13) were independent predictors of in-hospital mortality.


CONCLUSIONS
Elevated cTnI is a strong and independent predictor of in-hospital death in patients admitted for acutely exacerbated COPD.
Baillard
Christophe
C
Department of Anaesthesiology and Intensive Care Unit, Avicenne Hospital, UPRES 34-09-Parus XIII University-AP-HP, Bobigny, France. christophe.baillard@avc.ap-hop-paris.fr
Boussarsar
Mohamed
M
Fosse
Jean-Philippe
JP
Girou
Emmanuelle
E
Le Toumelin
Philippe
P
Cracco
Christophe
C
Jaber
Samir
S
Cohen
Yves
Y
Brochard
Laurent
L
D000368:Aged; D016009:Chi-Square Distribution; D015897:Comorbidity; D005260:Female; D017052:Hospital Mortality; D006801:Humans; D016015:Logistic Models; D008297:Male; D008875:Middle Aged; D011237:Predictive Value of Tests; D011446:Prospective Studies; D029424:Pulmonary Disease, Chronic Obstructive / Q000097:blood* / Q000401:mortality; D012307:Risk Factors; D012720:Severity of Illness Index; D018709:Statistics, Nonparametric; D019210:Troponin I / Q000097:blood*
D019210:Troponin I