Cardiac Troponin I in Acute Exacerbation of Chronic Obstructive Pulmonary Disease

COPD is one of the leading causes of death worldwide and is very commonly associated with cardiovascular disorders and comorbidities. This study was carried out to assess the prognostic significance of cardiac troponin I when measured during an acute exacerbation of COPD.

Material: This is a cross-sectional study conducted for a period of 18 months among a total of 50 study subjects who presented with an acute exacerbation of COPD to the Medicine/Emergency Medicine/Pulmonary Medicine inpatient department after consideration of the inclusion and exclusion criteria. All the study subjects were tested for cardiac troponin I at admission and 24hrs later. Levels above 0.05 were considered positive. A detailed history, examination and relevant investigations were performed. All the categorical variables were expressed in proportions and continuous variables were expressed in means and standard deviation or medians and interquantile ranges. Chi square test was done to analyze the categorical variables. A p value of <0.05 was considered statistically significant.

Observation: Among the 50 patients, 20 were females and 30 were males. cTnI was positive in 40% of patients. Patients with cTnI positive were included in group 1 and those with a negative cTnI were considered to be in group 2. Prevalence of comorbidities, the need for ICU admission and ventilatory support and in hospital mortality was higher in group 1 when compared to group 2.

Conclusion: Cardiac Troponin I is a strong and independent predictor of in hospital mortality in patients admitted with acute exacerbation of COPD. Patients with elevated Troponin I had longer duration of COPD and a higher incidence of IHD. Cardiac Troponin I elevation was associated with a greater need for ICU admission and ventilatory support.