Acute Exacerbation of Chronic Obstructive Pulmonary Disease: Cardiovascular Links

Table 1

Summary of studies analyzing the prognostic and diagnostic importance of serum troponins in patients admitted to hospital for acute exacerbations of COPD.

Author	Study design	Sample size	Controls	Follow-up (months)	Associations with elevated troponin
Fruchter and Yigla [83]; Israel	Retrospective	83	953 without troponins and 99 with low cTnI	≤72	Increased long-term mortality
Martins et al. [95] Portugal	Retrospective	121	52 with undetectable cTnI	>18	Age, heart failure, atrial arrhythmia, elevated BNP, need for NIPPV; Increased LOS and long-term mortality
Harvey and Hancox [96]; New Zealand	Retrospective	47	147 with undetectable cTnI or cTnT	Until discharge	Older age, lower pulse oximetry, acidosis, hypercapnea; Longer length of stay in hospital
Brekke et al. [138]; Norway	Retrospective	173	897 without troponins and 223 with undetectable cTnT	<66	Increased all-cause mortality; (HR 1.64, 95% CI 1.15–2.34)
Brekke et al. [143]; Norway	Retrospective	321	120 with undetectable cTnT	Discharge	Neutrophilia, increased creatinine, cardiac infarction injury score, low hemoglobin, and tachycardia
Odigie-Okon et al. [137]; USA	Prospective	19	95 without an ischemic ECG and undetectable cTnT	First 24 hours from admission	Presence of acute coronary syndrome or marker of ischemia
Marcun et al. [87] Slovenia	Prospective	32 at admission; 15 at discharge	95 admitted with; cTnT ≤ 0.012 ng/L and 112 discharged with; cTnT ≤ 0.012 ng/L	6	Increased risk of repeat hospitalization (HR 2.89, 95% CI 1.13–7.36)
Høiseth et al. [139]; Norway	Prospective	73	26 with a low highly sensitive cTnT	<36	Increased long-term mortality and higher mortality with tachycardia
Høiseth et al. [141]; Norway	Prospective	49	50 with a low geometric mean of hs-cTnT	Discharge	Age, arterial hypertension, tachycardia, creatinine
Baillard et al. [142]; France	Prospective	13	58 with normal troponins	Discharge	In-hospital mortality
Soyseth et al. [136] Norway	Prospective	50	124 stable COPD patients admitted to a rehabilitation hospital	Until discharge	No association between retrosternal chest pain or T wave inversions on ECG and elevated troponin
Chang et al. [144]; New Zealand	Prospective	40	201 with undetectable cTnT	12	Increased 30-day mortality

LOS: length of stay; LVH: left ventricular hypertrophy; cTnI: cardiac troponin I; cTnT: cardiac troponin T; AECOPD: acute exacerbation of COPD; ECG: electrocardiogram.