title: Cardiac injury in patients with COPD presenting with dyspnea: a pilot study.
abstract: OBJECTIVE
  The aim of this pilot study was to test the hypothesis that myocardial ischemia complicates the management of some patients with chest-pain-free chronic obstructive pulmonary disease (COPD) exacerbations.
  
  
  METHODS
  In this prospective, observational, cohort study, patients admitted to a 350-bed community teaching hospital, with dyspnea and a primary diagnosis of COPD exacerbation, were followed for enzymatic and electrocardiographic evidence of myocardial ischemia for the first 24 hours of hospital admission.
  
  
  RESULTS
  A total of 114 patients were studied. Overall, four patients had definite myocardial infarctions, one had definite myocardial ischemia and 14 had possible myocardial ischemia. In multiple logistic regression models, age, number of coronary risk factors, and amount of administered albuterol were not associated with myocardial injury.
  
  
  CONCLUSIONS
  While unrecognized myocardial injury is relatively rare in patients with an exacerbation of COPD, it occurs frequently enough to warrant some caution since beta-agonists are the mainstays of therapy.
authors.affiliation: Bridgeport Hospital and Yale University School of Medicine, Bridgeport, CT 06610, USA.
authors.forename: Esosa
authors.initials: E
authors.lastname: Odigie-Okon
authors.forename: Bryan
authors.initials: B
authors.lastname: Jordan
authors.forename: Sylvester
authors.initials: S
authors.lastname: Dijeh
authors.forename: Armand
authors.initials: A
authors.lastname: Wolff
authors.forename: Razvan
authors.initials: R
authors.lastname: Dadu
authors.forename: Priyanka
authors.initials: P
authors.lastname: Lall
authors.forename: Stuart
authors.initials: S
authors.lastname: Zarich
authors.forename: Yaw
authors.initials: Y
authors.lastname: Amoateng-Adjepong
authors.forename: Constantine A
authors.initials: CA
authors.lastname: Manthous
mesh_terms: D000318:Adrenergic beta-Agonists; D000368:Aged; D000369:Aged, 80 and over; D015415:Biomarkers / Q000097:blood; D003237:Connecticut; D000075202:Contraindications; D004417:Dyspnea / Q000209:etiology*; D004562:Electrocardiography; D005260:Female; D006801:Humans; D016015:Logistic Models; D008297:Male; D008875:Middle Aged; D017202:Myocardial Ischemia / Q000097:blood / Q000175:diagnosis / Q000209:etiology*; D016017:Odds Ratio; D010865:Pilot Projects; D011446:Prospective Studies; D029424:Pulmonary Disease, Chronic Obstructive / Q000150:complications* / Q000188:drug therapy; D018570:Risk Assessment; D012307:Risk Factors; D014336:Troponin / Q000097:blood
chemical_list: D000318:Adrenergic beta-Agonists; D015415:Biomarkers; D014336:Troponin