C. Nirmala Devi1, E. Dhivya2 Ramakrishnan C.3
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.
