Conventional vs high-sensitive troponins in acute exacerbations of chronic obstructive pulmonary disease

Abstract

BackgroundCardiac troponins (cTn), either conventional or high-sensitive (hscTn) assays, are often performed during acute exacerbations of chronic obstructive pulmonary disease (AECOPD). ObjectivesTo compare factors affecting abnormal conventional cTn and hscTn. MethodsWe retrospectively studied data from AECOPD patients with conventional or hscTn performed at presentation. Binary logistic regression was used to identify predictors for abnormal conventional cTn (>0.5 ug/L) and hscTn (>40 ng/L). ResultsThere were 466 patients in the conventional cTn and 313 patients in the hscTn groups. Ischaemic electrocardiographic change was the only significant predictor for abnormal conventional cTn (OR 6.662 [CI 1.233–35.990], p = 0.028) while B-type natriuretic peptide levels (Adj OR 1.004 [CI 1.000–1.006], p = 0.010) and SpO2/FiO2 ratio (Adj OR 0.115 [CI 0.017–0.069], p = 0.026) were significant predictors of abnormal hscTn. ConclusionsPredictors of abnormal cTn differ between assays and should be taken into consideration when interpreting cTn during AECOPD.