RT Journal Article
SR Electronic
T1 Diagnosis of myocardial infarction following hospitalisation for exacerbation of COPD
JF European Respiratory Journal
JO Eur Respir J
FD European Respiratory Society
SP 1097
OP 1103
DO 10.1183/09031936.00124811
VO 39
IS 5
A1 David A. McAllister
A1 John D. Maclay
A1 Nicholas L. Mills
A1 Andrew Leitch
A1 Philip Reid
A1 Ross Carruthers
A1 Jennifer O’Connor
A1 Lawrence McAlpine
A1 George Chalmers
A1 David E. Newby
A1 Elaine Clark
A1 Peter W. Macfarlane
A1 William MacNee
YR 2012
UL http://erj.ersjournals.com/content/39/5/1097.abstract
AB Cardiovascular disease is common in chronic obstructive pulmonary disease (COPD) and raised troponin is common in exacerbations. However, the prevalence of myocardial infarction following hospitalisation for exacerbation of COPD is unknown. Patients aged ≥40 yrs hospitalised with acute exacerbation of COPD (n=242) with ≥10 pack-yrs 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 ECGs and troponin levels were obtained. The mean±sd age was 69±9 yrs; 108 (45%) patients were male and almost half were current smokers. 124 (51%; 95% CI 48–58%) patients had chest pain, which was exertional in 62 (26%). 24 (10%) had raised troponin, among whom, 20 (8.3%; 95% CI 5.1–12.5%) 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, one in 12 patients met the criteria for myocardial infarction. Whether these patients would benefit from further cardiac investigation is unknown.