Cardiac biomarkers of prognostic importance in chronic obstructive pulmonary disease.
COPD
Electrocardiography
Mortality
Multimorbidity
Myocardial ischemia
Troponin
Journal
Respiratory research
ISSN: 1465-993X
Titre abrégé: Respir Res
Pays: England
ID NLM: 101090633
Informations de publication
Date de publication:
26 Jun 2020
26 Jun 2020
Historique:
received:
30
01
2020
accepted:
18
06
2020
entrez:
28
6
2020
pubmed:
28
6
2020
medline:
22
5
2021
Statut:
epublish
Résumé
Ischemic heart disease is common in COPD and associated with worse prognosis. This study aimed to investigate the presence and prognostic impact of biomarkers of myocardial injury and ischemia among individuals with COPD and normal lung function, respectively. In 2002-04, all individuals with airway obstruction (FEV Hs-cTnI concentrations were above the risk stratification threshold of ≥5 ng/L in 31.1 and 24.9% of those with COPD and normal lung function, respectively. Ischemic ECG abnormalities were present in 14.8 and 13.4%, while 7.7 and 6.6% had both elevated hs-cTnI concentrations and ischemic ECG abnormalities. The 5-year cumulative mortality was higher in those with COPD than those with normal lung function (13.6% vs. 7.7%, p < 0.001). Among individuals with COPD, elevated hs-cTnI both independently and in combination with ischemic ECG abnormalities were associated with an increased risk for death (adjusted hazard ratio [HR]; 95% confidence interval [CI] 2.72; 1.46-5.07 and 4.54; 2.25-9.13, respectively). Similar associations were observed also among individuals with COPD without reported ischemic heart disease. In this study, elevated hs-cTnI concentrations in combination with myocardial ischemia on the electrocardiogram were associated with a more than four-fold increased risk for death in a population-based COPD-cohort, independent of disease severity.
Sections du résumé
BACKGROUND
BACKGROUND
Ischemic heart disease is common in COPD and associated with worse prognosis. This study aimed to investigate the presence and prognostic impact of biomarkers of myocardial injury and ischemia among individuals with COPD and normal lung function, respectively.
METHODS
METHODS
In 2002-04, all individuals with airway obstruction (FEV
RESULTS
RESULTS
Hs-cTnI concentrations were above the risk stratification threshold of ≥5 ng/L in 31.1 and 24.9% of those with COPD and normal lung function, respectively. Ischemic ECG abnormalities were present in 14.8 and 13.4%, while 7.7 and 6.6% had both elevated hs-cTnI concentrations and ischemic ECG abnormalities. The 5-year cumulative mortality was higher in those with COPD than those with normal lung function (13.6% vs. 7.7%, p < 0.001). Among individuals with COPD, elevated hs-cTnI both independently and in combination with ischemic ECG abnormalities were associated with an increased risk for death (adjusted hazard ratio [HR]; 95% confidence interval [CI] 2.72; 1.46-5.07 and 4.54; 2.25-9.13, respectively). Similar associations were observed also among individuals with COPD without reported ischemic heart disease.
CONCLUSIONS
CONCLUSIONS
In this study, elevated hs-cTnI concentrations in combination with myocardial ischemia on the electrocardiogram were associated with a more than four-fold increased risk for death in a population-based COPD-cohort, independent of disease severity.
Identifiants
pubmed: 32590988
doi: 10.1186/s12931-020-01430-z
pii: 10.1186/s12931-020-01430-z
pmc: PMC7318493
doi:
Substances chimiques
Biomarkers
0
Troponin I
0
Types de publication
Journal Article
Observational Study
Langues
eng
Sous-ensembles de citation
IM
Pagination
162Subventions
Organisme : British Heart Foundation
ID : FS/16/14/32023
Pays : United Kingdom
Organisme : The VisareNorr Fund/Northern County Council's Regional Federation
ID : N/A
Organisme : British Heart Foundation
ID : Butler Senior Clinical Research Fellowship FS/16/14/32023
Pays : United Kingdom
Organisme : The County Council of Västerbotten
ID : N/A
Organisme : The County Council of Norrbotten
ID : N/A
Organisme : The Swedish Respiratory Society
ID : N/A
Organisme : The Swedish Heart and Lung Association
ID : N/A
Organisme : Umeå University
ID : N/A
Organisme : The Swedish Heart and Lung foundation
ID : N/A
Organisme : King Gustaf V and Queen Victoria's Freemason Foundation
ID : N/A
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