Arne Didrik Høiseth1,2, Jon Brynildsen1,2, Tor-Arne Hagve3,4, Geir Christensen2, Vidar Søyseth1,4, Torbjørn Omland, Omland Torbjørn1,2, Helge Røsjø1,2. 1. a Division of Medicine , Akershus University Hospital , Lørenskog , Norway . 2. b Center for Heart Failure Research and K.G. Jebsen Cardiac Research Centre, Institute of Clinical Medicine; University of Oslo , Oslo , Norway . 3. c Division of Diagnostics and Technology , Akershus University Hospital , Lørenskog , Norway , and. 4. d Institute for Experimental Medical Research, Oslo University Hospital , Oslo , Norway.
Abstract
CONTEXT: Troponin (hs-TnT) levels predict mortality after acute exacerbation of COPD (AECOPD). Whether this is independent of heart failure (HF) is not established. MATERIAL AND 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). CONCLUSION: 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.
CONTEXT: Troponin (hs-TnT) levels predict mortality after acute exacerbation of COPD (AECOPD). Whether this is independent of heart failure (HF) is not established. MATERIAL AND 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). CONCLUSION: 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: Frederik C Loft; Søren M Rasmussen; Mikkel Elvekjaer; Camilla Haahr-Raunkjaer; Helge B D Sørensen; Eske K Aasvang; Christian S Meyhoff Journal: Acta Anaesthesiol Scand Date: 2022-03-14 Impact factor: 2.274