Cardiac Troponin I Levels in Acute Exacerbation of COPD Patients: A Cross-sectional Study

Abstract

Introduction: Chronic Obstructive Pulmonary Disease (COPD) is associated with right ventricular overloading and pulmonary hypertension. In COPD patients co-morbidities determine the outcome and quality of life. Cardiac Troponins (cTn) are suspected to be elevated in right ventricular failure. Aim: To find the incidence of cardiac Troponin-I levels and association of elevated cTnI levels with clinical outcome in acute exacerbation of COPD. Materials and Methods: The cross-sectional study comprised of 102 patients with acute exacerbation of COPD. These patients were admitted in medical wards and Intensive Care Unit (ICU) in the Department of General Medicine, Karnataka Institute of Medical Sciences Hospital, Hubli, Karnataka, India, from 2018-2020. Investigations included complete blood count, renal function tests, serum electrolytes, liver function tests, Electrocardiography (ECG), ECHO and chest X-ray. Association of cardiac troponin I and acute exacerbation of COPD was evaluated. The cTnI level ≥0.01ng/mL was considered positive. Results: The serum cTnI was found to be positive in 43 (42.2%) patients with acute exacerbation of COPD. The patients with cTnI levels ≥0.01 ng/mL had significantly higher need for Non Invasive Ventilation (NIV) 32 (74.4%), invasive ventilation support 5 (11.6%), prolonged duration of hospital stay 33 (76.7%), and higher mortality 15 (34.9%) rate as compared to patients having cTnI <0.01 ng/mL. Conclusion: The cTnI is elevated in a significant subset of patients with acute exacerbation of COPD. cTnI elevation was associated with higher need for NIV and invasive ventilator support. Levels of cTnI ≥0.01 ng/mL may be considered as a biomarker to predict morbidity and mortality in acute exacerbation of COPD patients.