Abstract
Patients aged ≥40 hospitalised with acute exacerbation of COPD (n=242) with ≥10 pack-years of cigarette smoking were included in a prospective case series conducted in four hospitals. Patients whose primary presenting complaint was chest pain, or who had an alternative diagnosis were excluded. Chest pain histories, serial electrocardiographs, and troponin levels were obtained.
The mean (SD) age was 69 (9), 108 (45%) were male and almost half were current smokers. 124 (51%, 95% CI 48 to 58%) had chest pain, which was exertional in 62 (26%). 24 (10%) had raised troponin, among whom, 20 (8.3%, 95% CI 5.1 to 12.5) had chest pain and/or serial ECG changes, fulfilling the 2007 Universal Definition of Myocardial Infarction. Neither chest pain (P=0.77) nor serial ECG changes (P=0.39) were associated with raised troponin.
Raised troponin, chest pain and serial ECG changes are common in patients admitted to hospital with exacerbation of COPD. Overall 1 in 12 patients met the criteria for myocardial infarction. Whether these patients would benefit from further cardiac investigation is unknown.
- ERS