A Study of Cardiac Troponin T- in Acute Exacerbation of Chronic Obstructive Pulmonary Disease

COPD is a leading cause of morbidity and mortality worldwide. Currently ranked as 4th leading cause of death worldwide. OBJECTIVE: This study was aimed to evaluate the incidence of cTnT elevation in COPD exacerbation patients and to see if cardiac troponin T has prognostic significance during an acute exacerbation of COPD. Design: Prospective study. Participants: Sample of 50 adult patients (both male and female) admitted to Government Rajaji Hospital, Madurai with signs and symptoms of acute exacerbation of COPD. METHODS: Blood samples for cTnT were measured on admission and 24 hrs later using quantitative assay by ELISA method. Levels above 0.017 μg / L were taken as positive. Demographic data, history & symptoms were recorded. Clinical examination & investigations were done on each patient. RESULTS: 19 patients had elevated cTnT levels. They were divided into two groups, group 1 included patients with cTnT positive, group 2 with cTnT negative. All patients had increased breathlessness. Majority was males, M: F = 11.5: 1. 58% were current smokers. Mean duration of COPD was high (6.42yrs) in group 1 as well as mean SpO2 was 75% (low) in group 1. RA, RV dilation & severe pulmonary hypertension were higher in group 1. cTnT elevation significantly correlated with ICU admission, need for ventilator, ICU & hospital stay duration. CONCLUSION: cTnT is elevated in significant subset of patients with COPD exacerbation. Among them, COPD duration was high, mean SpO2 was low. It was an independent predictor of need for ICU admission and ventilator support. Significant difference in length of stay in ICU (or) hospital was found among two groups. It can be used as marker to identify patients at higher risk at the time of admission