Intensive Care Medicine

, Volume 29, Issue 4, pp 584–589

Cardiac troponin I in patients with severe exacerbation of chronic obstructive pulmonary disease

  • Christophe Baillard
  • Mohamed Boussarsar
  • Jean-Philippe Fosse
  • Emmanuelle Girou
  • Philippe Le Toumelin
  • Christophe Cracco
  • Samir Jaber
  • Yves Cohen
  • Laurent Brochard
Original

DOI: 10.1007/s00134-003-1635-0

Cite this article as:
Baillard, C., Boussarsar, M., Fosse, JP. et al. Intensive Care Med (2003) 29: 584. doi:10.1007/s00134-003-1635-0

Abstract

Objectives

Co-morbid conditions including risk factors for cardiovascular diseases and left ventricular dysfunction are common in patients with chronic obstructive pulmonary disease (COPD). This study assessed the incidence of cardiac troponin I (cTnI) elevation, a specific marker for cardiac injury, and its prognostic significance during severe exacerbation of COPD.

Design

Prospective cohort study.

Setting

Two intensive care units.

Participants

Seventy-one consecutive patients admitted for severe exacerbation of COPD.

Intervention

None.

Measurements and results

Cardiac troponin I was assayed in blood samples obtained on admission and 24 h later (Stratus II immunoassay analyser, Dade International). Levels above 0.5 ng/ml were considered positive. The following data were recorded prospectively: clinical symptoms, co-morbidities, cause of the exacerbation, diagnostic procedures and treatment, general severity score (SAPS II) and in-hospital outcome. CTnI was positive in 18% of patients (95% confidence interval (CI95), 11–29%), with a median value at 1.00 ng/ml; CI95 (0.60–1.70). Eighteen patients died in the hospital (25%; CI95, 17–37%). Only cTnI (adjusted odds ratio (ORa), 6.52; CI95,1.23–34.47) and SAPS II 24 h after admission (ORa, 1.07; CI95, 1.01–1.13) were independent predictors of in-hospital mortality.

Conclusion

Elevated cTnI is a strong and independent predictor of in-hospital death in patients admitted for acutely exacerbated COPD.

Keywords

Chronic obstructive pulmonary diseaseCardiac troponin ICardiac injuryAcute respiratory failure

Copyright information

© Springer-Verlag 2003

Authors and Affiliations

  • Christophe Baillard
    • 1
  • Mohamed Boussarsar
    • 2
  • Jean-Philippe Fosse
    • 1
  • Emmanuelle Girou
    • 3
  • Philippe Le Toumelin
    • 1
  • Christophe Cracco
    • 2
  • Samir Jaber
    • 2
  • Yves Cohen
    • 1
  • Laurent Brochard
    • 2
  1. 1.Department of Anaesthesiology and Intensive Care UnitAvicenne HospitalBobignyFrance
  2. 2.Intensive Care UnitHenri Mondor University Hospital, Assistance Publique-Hôpitaux de ParisCréteilFrance
  3. 3.Infection Control UnitHenri Mondor University Hospital, Assistance Publique-Hôpitaux de Paris CréteilFrance