Value of troponin T in assessment of the cardiopulmonary relationships in the patients with underlying chronic obstructive pulmonary disease hospitalized with acute coronary syndrome

The analysis of troponin T (TnT) blood levels in the patients with acute coronary syndrome (ACS) and the underlying chronic obstructive pulmonary disease (COPD) is relevant to assessment of the cardiovascular prognosis and the risk of respiratory complications.

The aim of the study was to investigate TnT levels in the patients hospitalized with ACS and underlying COPD in order to analyze the cardiopulmonary relationships.

Methods. 52 patients (29 men and 23 women) were divided into 2 groups depending on outcomes of ACS: the 1st group - 30 patients (57.7%) with acute myocardial infarction (AMI); the 2nd group - 22 patients (42.3%) without AMI. The acute exacerbation of COPD (AECOPD) was found in 33 patients (63.5%) upon admission to the hospital, and 19 patients (36.5%) did not have AECOPD. All patients underwent spirometry, the assessment of symptoms severity by COPD Assessment Test (CAT test) and the analyses for the level of TnT and oxygen saturation.

Results. AECOPD was found upon admission in the 1st group more often than in the 2nd group: 76.7% vs 45.5% (p = 0.022). The patients with AECOPD had significantly higher levels of TnT than patients without AECOPD in both groups: 0.78 ± 0.17 and 0.59 ± 0.14 ng/mL respectively (p = 0.014) in the 1st group vs 0.19 ± 0.08 and 0.11 ± 0.04 ng/mL respectively (p = 0.002) in the 2nd group. In the 2nd group, 8 patients (80.0%) with AECOPD and 4 patients (33.3%) without AECOPD had levels of TnT in the range of «a myocardial necrosis» (p = 0.029) in the absence of AMI. The inverse correlation between levels of TnT and forced expiratory volume in 1 second (FEV1) was also found (R = 0.376; p = 0.009).

Conclusion. Thus, the significantly increased levels of TnT in patients with ACS are associated with AECOPD upon admission, development of AMI and deterioration of the indexes of spirometry. It was shown that blood levels of TnT were significantly higher in the patients with AECOPD than in the patients with stable COPD in absence of AMI.

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