Department of Respiratory and Critical Care Medicine, Tan Tock Seng Hospital, 11 Jln Tan Tock Seng, Singapore 308433, Singapore.
Department of Cardiology, Tan Tock Seng Hospital, Singapore, 11 Jln Tan Tock Seng, Singapore 308433, Singapore.
Heart Lung. 2021 May-Jun;50(3):430-436. doi: 10.1016/j.hrtlng.2021.02.002. Epub 2021 Feb 21.
Cardiac troponins (cTn), either conventional or high-sensitive (hscTn) assays, are often performed during acute exacerbations of chronic obstructive pulmonary disease (AECOPD).
To compare factors affecting abnormal conventional cTn and hscTn.
We retrospectively studied data from AECOPD patients with conventional or hscTn performed at presentation. Binary logistic regression was used to identify predictors for abnormal conventional cTn (>0.5 ug/L) and hscTn (>40 ng/L).
There were 466 patients in the conventional cTn and 313 patients in the hscTn groups. Ischaemic electrocardiographic change was the only significant predictor for abnormal conventional cTn (OR 6.662 [CI 1.233-35.990], p = 0.028) while B-type natriuretic peptide levels (Adj OR 1.004 [CI 1.000-1.006], p = 0.010) and SpO/FiO ratio (Adj OR 0.115 [CI 0.017-0.069], p = 0.026) were significant predictors of abnormal hscTn.
Predictors of abnormal cTn differ between assays and should be taken into consideration when interpreting cTn during AECOPD.
在慢性阻塞性肺疾病（COPD）急性加重期（AECOPD）期间，常进行心肌肌钙蛋白（cTn），无论是常规还是高敏（hscTn）检测。
比较影响常规 cTn 和 hscTn 异常的因素。
我们回顾性研究了就诊时进行常规或 hscTn 检测的 AECOPD 患者的数据。采用二项逻辑回归分析确定常规 cTn（>0.5μg/L）和 hscTn（>40ng/L）异常的预测因素。
常规 cTn 组有 466 例患者，hscTn 组有 313 例患者。心电图缺血改变是常规 cTn 异常的唯一显著预测因素（OR 6.662 [CI 1.233-35.990]，p=0.028），而 B 型利钠肽水平（调整后 OR 1.004 [CI 1.000-1.006]，p=0.010）和 SpO/FiO 比值（调整后 OR 0.115 [CI 0.017-0.069]，p=0.026）是 hscTn 异常的显著预测因素。
两种检测方法中 cTn 异常的预测因素不同，在解释 AECOPD 期间的 cTn 时应加以考虑。
