Troponin T elevation and long-term mortality after COPD exacerbation

¹ Dept of Medicine and Faculty Division, , Akershus University Hospital, N-1478 Lørenskog, Norway
² Dept of Radiology, Akershus University Hospital, N-1478 Lørenskog, Norway

^* To whom correspondence should be addressed. E-mail: pal.brekke{at}ahus.no.

	Abstract

Patients with chronic obstructive pulmonary disease (COPD) are at increased risk of cardiovascular disease, and exacerbations increase strain on the heart. We have investigated the prognostic value of elevated circulating levels of cardiac troponins seen during COPD exacerbations.

From the hospital database, 897 patients discharged after treatment for COPD exacerbation in the years 2000–2003 were identified and followed until 30th June 2005. Median observation time was 1.9 years. In 396 patients, measurements of cardiac-specific Troponin T (cTnT) were available. Levels of cTnT 0.04 µg·L^-1 were considered elevated. Clinical data were retrieved from patient records. Date of death was obtained from the Central National Registry. To balance the non-randomised nature of available cTnT measurements, an exposure propensity score (EPS) for cTnT sampling was calculated, and used in regression analyses.

After adjusting for EPS in Cox regression analyses, elevated cTnT was significantly associated with increased all-cause mortality in the observation period, with an HR of 1.64 (95% confidence interval: 1.15–2.34).

COPD patients with cTnT elevation during exacerbation are at increased risk of death after discharge.