The study on association of elevated cardiac biomarker in patients of acute exacerbation of chronic obstructive pulmonary disease

Abstract

Chronic obstructive pulmonary disease (COPD) is the third leading cause of death worldwide, and also resulting in economic and social burden which is substantial and is significantly increasing with time. Chronic obstructive pulmonary disease is frequently associated with right ventricular loading and pulmonary hypertension. Study aimed to evaluate a possible association between cardiac biomarker levels and adverse events in hospitalized patients with Acute exacerbations of chronic obstructive pulmonary disease comorbidities are important determinants of outcome and quality of life of patients with chronic obstructive pulmonary disease. An observational, cross-sectional study was conducted on 89 patients with AECOPD admitted in the medicine emergency ward of Baba Raghav Das medical college and Nehru Hospital Gorakhpur India. Acute exacerbations of chronic obstructive pulmonary disease were diagnosed according to Global Initiative for chronic obstructive lung disease guidelines. cTnI levels were estimated at the time of admission by method based on chemiluminescence with other investigations. Levels ≥ 0.01ng/ml was taken as positive. Tabulation and statistical analysis were performed using Microsoft Excel and SPSS v.17.0 software. p –value< 0.05 at 95% confidence intervals taken as statistically significant. 89 patients with AECOPD were enrolled, among them mean age was 59.59±8.72. We found that cardiac biomarker elevation (cTnI≥0.01ng/ml) is significantly associated with increased mortality, duration of hospitalization, need of ventilation (both invasive or non-invasive) & cardiovascular morbidity. cTnI positivity predicted increased need of ICU admission and significantly increased duration of hospital stay (P=0.0001). cTnI positivity can prognosticate need of NIV or ventilator support. It was found in our study that ventilator support necessity & mortality was more in cTnI positive patients which shows statical significance (P=0.006).cTnI in AECOPD has close relation with exacerbation od disease, right ventricular dysfunction, so it can be used as prognostic marker for mechanical ventilation requirement in future.