Abstract
Background: Cardiovascular disease (CVD) is a common comorbidity in Chronic Obstructive Pulmonary Disease (COPD). Cardiac troponin elevation, indicating myocardial injury, is frequent during acute COPD exacerbations and associated with increased mortality. The prognostic value of circulating cardiac troponin T among COPD patients in the stable state of the disease is still unknown.
Aims and objectives: To assess the association between circulating cardiac troponin T measured by a high sensitive assay (hs-cTnT) and all-cause mortality among patients with stable COPD.
Methods: In a prospective cohort study we included 275 patients with stable COPD without prior diagnosis of CVD from the Akershus University Hospital's outpatient clinic and from Glittreklinikken, a pulmonary rehabilitation clinic, and recorded time to all-cause death.
Results: After a mean follow-up time of 2.8 years, 47 patients (17.1%) died. 180 patients (65%) had measurable hs-cTnT and 66 patients (24 %) had hs-cTnT above the normal range (≥14.0 ng/L). hs-cTnT concentrations in the ranges < 5.0, 5.0-13.9 and ≥ 14 ng/L were associated with crude mortality rates of 2.8, 4.4 and 11.0 per 100 patient-years, respectively. Adjusting for relevant covariates including lung function using Cox regression analysis, the hazard ratios (95 % confidence intervals) for death were 1.7 (0.7-3.8) and 2.9 (1.2-6.9) among patients having hs-cTnT 5.0-13.9 and ≥ 14 ng/L, respectively, compared to patients with hs-cTnT < 5.0 ng/L.
Conclusions: hs-cTnT elevation is frequently present and associated with increased mortality in stable COPD, independent of COPD-severity.
- Copyright ©ERS 2015