title: The influence of heart failure co-morbidity on high-sensitivity troponin T levels in COPD exacerbation in a prospective cohort study: data from the Akershus cardiac examination (ACE) 2 study.
abstract: BACKGROUND
  Troponin (hs-TnT) levels predict mortality after acute exacerbation of COPD (AECOPD). Whether this is independent of heart failure (HF) is not established.
  
  
  METHODS
  Prospectively included AECOPD patients adjudicated for acute HF categorized into three groups: (A) AECOPD, but acute HF the primary cause for hospitalization; (B) AECOPD the primary cause, but co-existing myocardial dysfunction and (C) AECOPD without myocardial dysfunction.
  
  
  RESULTS
  About 103 AECOPD patients; 18% A, 27% B and 54% C. Hs-TnT level differed between the groups: (ng/l, median) A: 41, B: 25 and C: 15, p = 0.03 for A versus B and p = 0.005 for B versus C. During a median 826 days, 47% died. In Cox analysis, hs-TnT levels remained associated with mortality (hazard ratio per 10 ng/l 1.3, p < 0.0001).
  
  
  CONCLUSIONS
  hs-TnT levels are influenced by myocardial dysfunction/HF in AECOPD, but provide independent prognostic information. The prognostic merit of hs-TnT cannot be attributed to HF alone.
authors.affiliation: a Division of Medicine , Akershus University Hospital , Lørenskog , Norway .|b Center for Heart Failure Research and K.G. Jebsen Cardiac Research Centre, Institute of Clinical Medicine; University of Oslo , Oslo , Norway .
authors.forename: Arne Didrik
authors.initials: AD
authors.lastname: Høiseth
authors.affiliation: a Division of Medicine , Akershus University Hospital , Lørenskog , Norway .|b Center for Heart Failure Research and K.G. Jebsen Cardiac Research Centre, Institute of Clinical Medicine; University of Oslo , Oslo , Norway .
authors.forename: Jon
authors.initials: J
authors.lastname: Brynildsen
authors.affiliation: c Division of Diagnostics and Technology , Akershus University Hospital , Lørenskog , Norway , and.|d Institute for Experimental Medical Research, Oslo University Hospital , Oslo , Norway.
authors.forename: Tor-Arne
authors.initials: TA
authors.lastname: Hagve
authors.affiliation: b Center for Heart Failure Research and K.G. Jebsen Cardiac Research Centre, Institute of Clinical Medicine; University of Oslo , Oslo , Norway .
authors.forename: Geir
authors.initials: G
authors.lastname: Christensen
authors.affiliation: a Division of Medicine , Akershus University Hospital , Lørenskog , Norway .|d Institute for Experimental Medical Research, Oslo University Hospital , Oslo , Norway.
authors.forename: Vidar
authors.initials: V
authors.lastname: Søyseth
authors.forename: Torbjørn
authors.initials: T
authors.lastname: Omland
authors.affiliation: a Division of Medicine , Akershus University Hospital , Lørenskog , Norway .|b Center for Heart Failure Research and K.G. Jebsen Cardiac Research Centre, Institute of Clinical Medicine; University of Oslo , Oslo , Norway .
authors.forename: Omland
authors.initials: O
authors.lastname: Torbjørn
authors.affiliation: a Division of Medicine , Akershus University Hospital , Lørenskog , Norway .|b Center for Heart Failure Research and K.G. Jebsen Cardiac Research Centre, Institute of Clinical Medicine; University of Oslo , Oslo , Norway .
authors.forename: Helge
authors.initials: H
authors.lastname: Røsjø
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D015415:Biomarkers / Q000097:blood*; D015897:Comorbidity; D005260:Female; D006333:Heart Failure / Q000097:blood* / Q000175:diagnosis / Q000453:epidemiology; D006334:Heart Function Tests / Q000706:statistics & numerical data; D006760:Hospitalization / Q000706:statistics & numerical data; D006801:Humans; D016018:Least-Squares Analysis; D016014:Linear Models; D008297:Male; D008875:Middle Aged; D009203:Myocardial Infarction / Q000097:blood / Q000175:diagnosis / Q000453:epidemiology; D009664:Norway / Q000453:epidemiology; D011379:Prognosis; D016016:Proportional Hazards Models; D011446:Prospective Studies; D029424:Pulmonary Disease, Chronic Obstructive / Q000097:blood* / Q000175:diagnosis / Q000453:epidemiology; D020107:Troponin T / Q000097:blood*
chemical_list: D015415:Biomarkers; D020107:Troponin T
keywords: COPD; epidemiology; heart failure; troponin