KIMS, Bangalore.
J Assoc Physicians India. 2022 Apr;70(4):11-12.
COPD is one of the leading causes of death worldwide and is very commonly associated with cardiovascular disorders and comorbidities. This study was carried out to assess the prognostic significance of cardiac troponin I when measured during an acute exacerbation of COPD.
This is a cross-sectional study conducted for a period of 18 months among a total of 50 study subjects who presented with an acute exacerbation of COPD to the Medicine/Emergency Medicine/Pulmonary Medicine inpatient department after consideration of the inclusion and exclusion criteria. All the study subjects were tested for cardiac troponin I at admission and 24hrs later. Levels above 0.05 were considered positive. A detailed history, examination and relevant investigations were performed. All the categorical variables were expressed in proportions and continuous variables were expressed in means and standard deviation or medians and interquantile ranges. Chi square test was done to analyze the categorical variables. A p value of <0.05 was considered statistically significant.
Among the 50 patients, 20 were females and 30 were males. cTnI was positive in 40% of patients. Patients with cTnI positive were included in group 1 and those with a negative cTnI were considered to be in group 2. Prevalence of comorbidities, the need for ICU admission and ventilatory support and in hospital mortality was higher in group 1 when compared to group 2.
Cardiac Troponin I is a strong and independent predictor of in hospital mortality in patients admitted with acute exacerbation of COPD. Patients with elevated Troponin I had longer duration of COPD and a higher incidence of IHD. Cardiac Troponin I elevation was associated with a greater need for ICU admission and ventilatory support.
本研究旨在评估在 COPD 急性加重期测量时心脏肌钙蛋白 I 的预后意义。
这是一项为期 18 个月的横断面研究,共纳入 50 名因 COPD 急性加重而入住内科/急诊/呼吸内科的患者,符合纳入和排除标准。所有患者入院时和 24 小时后均检测心脏肌钙蛋白 I。水平超过 0.05 被认为是阳性。进行了详细的病史、检查和相关调查。所有分类变量均以比例表示,连续变量以均值和标准差或中位数和四分位数范围表示。卡方检验用于分析分类变量。p 值 <0.05 被认为具有统计学意义。
在 50 名患者中,20 名女性,30 名男性。40%的患者 cTnI 阳性。cTnI 阳性的患者被纳入组 1,cTnI 阴性的患者被认为是组 2。与组 2 相比,组 1 的合并症患病率、需要 ICU 入院和通气支持以及住院死亡率更高。
心脏肌钙蛋白 I 是 COPD 急性加重患者住院死亡率的一个强有力的独立预测因子。肌钙蛋白 I 升高的患者 COPD 持续时间更长,冠心病发病率更高。肌钙蛋白 I 升高与 ICU 入院和通气支持的需求增加有关。