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Prognostic value of cardiac troponin I in patients with COPD acute exacerbation.
MedLine Citation:
PMID:  19915228     Owner:  NLM     Status:  In-Process    
Abstract/OtherAbstract:
BACKGROUND: Chronic obstructive pulmonary disease (COPD) is frequently associated with right ventricular loading and pulmonary hypertension. We aimed to evaluate a possible association between cardiac troponin I (cTnI) levels and adverse events in hospitalised patients with acute exacerbation of COPD . METHODS: Retrospective cohort study, with analysis of admissions for acute exacerbation of COPD , with cTnI obtained in the first 48 hours of admission. A positive cTnI test was defined as 0.012 ng/ml or higher (99th percentile). Baseline and peak troponin I levels were taken as independent variables, and outcome variables included length of hospital stay, complications during hospitalisation, and in-hospital and extra-hospital mortality (evaluated 18 months post-discharge). RESULTS: Data concerned 173 patients (105 male, 68 female), with a median age of 77 years (interquartile range of 11 years). The median baseline cTnI was 0.030 ng/ml (n=173), and the median peak cTnI was 0.040 ng/ml (n=173; absolute peak value of 1.260 ng/ml). Nearly 70% of cases had a positive cTnI at admission. Both baseline and peak cTnI correlated significantly with the need for noninvasive ventilatory support. We were not able to find significant differences in in-hospital survival associated with the two troponin groups, but overall 18-month survival was significantly higher among patients with lower values of baseline and peak cTnI. CONCLUSIONS: In patients hospitalised for acute COPD exacerbations, elevated baseline and peak cTnI were associated with a greater need for noninvasive ventilatory support and were significant predictors of 18-month overall survival.
Authors:
C S Martins; M J O Rodrigues; V P Miranda; J P L Nunes
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Publication Detail:
Type:  Journal Article    
Journal Detail:
Title:  The Netherlands journal of medicine     Volume:  67     ISSN:  1872-9061     ISO Abbreviation:  Neth J Med     Publication Date:  2009 Nov 
Date Detail:
Created Date:  2009-11-16     Completed Date:  -     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  0356133     Medline TA:  Neth J Med     Country:  Netherlands    
Other Details:
Languages:  eng     Pagination:  341-9     Citation Subset:  IM    
Affiliation:
Department of Medicine, Hospital Sao Joao, Porto, Portugal. Carlamrt@nortemedico.pt
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