English

Abstract

BACKGROUND Chronic obstructive pulmonary disease (COPD) is the third leading cause of death worldwide, and causes significant morbidity. Cardiovascular compromise is often associated with COPD, especially in acute exacerbations. The purpose of this study is to find out the incidence of elevation of troponin I levels in acute exacerbation of COPD patients and measuring the outcome in terms of need for ventilation (both invasive and non-invasive), length of hospital stay & mortality. METHODS This was a prospective analytical study done on 30 patients with acute exacerbation of COPD who were admitted in Government Mohan Kumaramangalam Medical College and Hospital, Salem, Tamil Nadu from December 2015 to June 2016. Troponin I levels were estimated for all patients on admission. A cut off value of more than 34.2 pg/ml was considered as elevation. A written informed consent was obtained. Clinical outcomes were studied by doing echocardiogram to measure the pulmonary artery systolic pressures (PASP), the need for mechanical ventilation (both invasive and non-invasive), length of stay in the hospital and mortality. RESULTS The pulmonary artery systolic pressures were 52 mm of Hg vs 40.3 mm Hg (P < 0.002), length of hospital stay was 9.67 vs 6.63 days (P < 0.027), patients who required ventilatory support were 13 out of the 30 and the mean duration of ventilation was higher in troponin I elevated patients 5.67 vs 3.57 days (P < 0.0015) and mortality was higher in patients with increased troponin I levels (2 deaths) when compared to patients with normal troponin I levels (1 death)and is statistically significant (P < 0.001). CONCLUSIONS There was a significant elevation of troponin I in acute exacerbation COPD patients. Our study concluded that the presence of elevated levels of troponin I in acute exacerbation of COPD is associated with increased morbidity in terms of increased need for mechanical ventilation, intensive care unit (ICU) stay and mortality. KEYWORDS Cardiac Biomarker, NIV, PASP, Troponin I