Abstract
Summary. The aim of this study was to evaluate diagnostic and prognostic values of heart injury biomarkers heart-type fatty acid binding protein (H-FABP) and troponin I (Tn I) in patients with acute exacerbations of chronic obstructive pulmonary disease (AECOPD). This was a prospective observational study. We enrolled 80 hospitalized patients with AECOPD (67 males, 13 females; age, 64.2 ± 7.8 years, BMI 25.8 ± 8.8 kg / m2). These patients underwent a complex diagnostic investigation including chest radiography, pulmonary function tests, echocardiography and measurement of serum Tn I (Biomerica), H-FABP (Hycult Biotech) and BNP-fragment (Biomedica). The main causes of AECOPD were purulent bronchitis (43.7 %), pneumonia (32.5 %), acute decompensated chronic heart failure (ADCHF) (12.5 %), and acute myocardial infarction (AMI) (11.3 %). BNP-fragment level was significantly higher in patients with pneumonia (p = 0.007), ADCHF (p = 0.002), AMI (p = 0.012) than in patients with purulent bronchitis. There was no significant difference between patients with pneumonia and ADCHF (p = 0.128), pneumonia and AMI (p = 0.651). Patients with AMI had higher H-FABP level than patients with purulent bronchitis (p = 0.003), but there was no significant difference between other groups of patients. A positive Tn I test was defined as > 0.5 ng / mL and Tn I level was increased in 21.3 % of cases, but there was no significant difference between the patient groups. The area under the ROC curve (AUC) to predict all-cause hospital mortality for BNP-fragment was 0.827 (95%CI: 0.729–0.626, p 0.5 ng / mL compared to survival in patients with Tn I < 0.5 ng / mL (log-rank test, p < 0.0001). In patients with AECOPD, Tn I and H-FABP levels were increased without coronary heart damage; these markers were strong predictors of all-cause hospital mortality in AECOPD.
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