@article {Vamadevanp555, author = {Padman R. Vamadevan and Andrew W. Hitchings and Dana Ahnood and Tejwant S. Grewal and Emma H. Baker}, title = {Relationships between elevated cardiac troponin levels in COPD exacerbations and subsequent cardiac investigation and management}, volume = {38}, number = {Suppl 55}, elocation-id = {p555}, year = {2011}, publisher = {European Respiratory Society}, abstract = {Background: Admission cardiac troponins (cTn) are elevated in 18-27\% patients with COPD exacerbations (BMC Pulm Med 2009;9:35). Clinicians often attribute this rise to co-existing inflammation, anaemia or renal impairment. However, elevated cTn is associated with a significantly increased 30-day post-admission mortality independently of these factors, and its presence indicates underlying myocardial injury. We determined proportions of patients undergoing cardiac investigation and receiving cardioprotective treatment following an exacerbation-related cardiac troponin I (cTnI) rise.Methods: 237 COPD patients (127 male, 73{\textpm}11yrs) admitted with exacerbations between July 2008-9, and with a measured cTnI within 24h of admission were retrospectively identified. Clinical information was retrieved using the electronic patient record.Results: Admission cTnI was {\textquotedblleft}undetectable{\textquotedblright} (U, \<0.02μg/L) in 15\%, {\textquotedblleft}measurable{\textquotedblright} (M, 0.02-0.05μg/L) in 59\% and {\textquotedblleft}elevated{\textquotedblright} (E, \>0.05μg/L) in 26\% of patients.View this table:Conclusions: cTnI elevation is not specific for coronary thrombosis, and rises in exacerbations may reflect demand ischaemia, direct cardiac damage, or myocardial strain. No guidelines exist regarding the optimal management of such patients. However, given their increased risk of early mortality, further cardiac investigation to reveal underlying mechanisms of cTnI release may enable appropriate therapeutic targeting and improve outcomes.}, issn = {0903-1936}, URL = {https://erj.ersjournals.com/content/38/Suppl_55/p555}, eprint = {https://erj.ersjournals.com/content}, journal = {European Respiratory Journal} }