Cardiac biomarkers predict outcome after hospitalisation for an acute exacerbation of chronic obstructive pulmonary disease

Robert Marcun, Alan Sustic, Pika Mesko Brguljan, Sasa Kadivec, Jerneja Farkas, Mitja Kosnik, Andrew J Stewart Coats, Stefan D. Anker, Mitja Lainscak

Research output: Contribution to journalArticle

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Abstract

Purpose: In chronic obstructive pulmonary disease (COPD), cardiovascular system is involved but less is known about role of specific cardiac biomarkers. We aimed to investigate associations between N-terminal pro B-type natriuretic peptide (NT-proBNP) and troponin T during hospitalisation with 6-month outcome. Methods: This was a prospective study conducted in consecutive patients hospitalized for an acute exacerbation of COPD. On admission, and at discharge, NT-proBNP and troponin T were measured, and echocardiography was performed. Hospitalisations and mortality were recorded for 6 months after discharge. Results: We included 127 patients (70 ± 10 years, 70% men, GOLD III/IV 87%). Left ventricular dysfunction was detected in 70 (55%) patients and diastolic dysfunction was the most common type (53 patients-42%). NT-proBNP and troponin T were elevated on admission in 60% and 36%, and at discharge in 28% and 19% of patients. During follow-up, 53 (42%) patients were hospitalized and 17 (13%) patients died. In Kaplan Meier analysis of survival curves, NT-proBNP on admission distinguished between deceased and surviving patients (p = 0.011) whilst troponin T at discharge separated hospitalized and non-hospitalized patients (p = 0.017). The adjusted Cox proportional hazard model confirmed these findings: discharge troponin T predicted hospitalisations (hazard ratio 2.89, 95% confidence interval 1.13-7.36) and admission NT-proBNP predicted mortality (hazard ratio 4.20, 95% confidence interval 1.07-14.01). Conclusions: Elevated NT-proBNP at discharge and troponin T on admission predict outcome in patients hospitalized for an acute exacerbation of COPD.

Original languageEnglish
Pages (from-to)156-159
Number of pages4
JournalInternational Journal of Cardiology
Volume161
Issue number3
DOIs
Publication statusPublished - Nov 29 2012

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Chronic Obstructive Pulmonary Disease
Hospitalization
Biomarkers
Troponin T
Brain Natriuretic Peptide
Peptide T
Kaplan-Meier Estimate
Confidence Intervals
Mortality
Left Ventricular Dysfunction
Cardiovascular System
Proportional Hazards Models
Echocardiography
Prospective Studies

Keywords

  • Biomarkers
  • Chronic obstructive pulmonary disease
  • Death
  • Hospitalisation
  • NT-proBNP
  • Troponin

ASJC Scopus subject areas

  • Cardiology and Cardiovascular Medicine

Cite this

Cardiac biomarkers predict outcome after hospitalisation for an acute exacerbation of chronic obstructive pulmonary disease. / Marcun, Robert; Sustic, Alan; Brguljan, Pika Mesko; Kadivec, Sasa; Farkas, Jerneja; Kosnik, Mitja; Coats, Andrew J Stewart; Anker, Stefan D.; Lainscak, Mitja.

In: International Journal of Cardiology, Vol. 161, No. 3, 29.11.2012, p. 156-159.

Research output: Contribution to journalArticle

Marcun, R, Sustic, A, Brguljan, PM, Kadivec, S, Farkas, J, Kosnik, M, Coats, AJS, Anker, SD & Lainscak, M 2012, 'Cardiac biomarkers predict outcome after hospitalisation for an acute exacerbation of chronic obstructive pulmonary disease', International Journal of Cardiology, vol. 161, no. 3, pp. 156-159. https://doi.org/10.1016/j.ijcard.2012.05.044
Marcun, Robert ; Sustic, Alan ; Brguljan, Pika Mesko ; Kadivec, Sasa ; Farkas, Jerneja ; Kosnik, Mitja ; Coats, Andrew J Stewart ; Anker, Stefan D. ; Lainscak, Mitja. / Cardiac biomarkers predict outcome after hospitalisation for an acute exacerbation of chronic obstructive pulmonary disease. In: International Journal of Cardiology. 2012 ; Vol. 161, No. 3. pp. 156-159.
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AU - Marcun, Robert

AU - Sustic, Alan

AU - Brguljan, Pika Mesko

AU - Kadivec, Sasa

AU - Farkas, Jerneja

AU - Kosnik, Mitja

AU - Coats, Andrew J Stewart

AU - Anker, Stefan D.

AU - Lainscak, Mitja

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N2 - Purpose: In chronic obstructive pulmonary disease (COPD), cardiovascular system is involved but less is known about role of specific cardiac biomarkers. We aimed to investigate associations between N-terminal pro B-type natriuretic peptide (NT-proBNP) and troponin T during hospitalisation with 6-month outcome. Methods: This was a prospective study conducted in consecutive patients hospitalized for an acute exacerbation of COPD. On admission, and at discharge, NT-proBNP and troponin T were measured, and echocardiography was performed. Hospitalisations and mortality were recorded for 6 months after discharge. Results: We included 127 patients (70 ± 10 years, 70% men, GOLD III/IV 87%). Left ventricular dysfunction was detected in 70 (55%) patients and diastolic dysfunction was the most common type (53 patients-42%). NT-proBNP and troponin T were elevated on admission in 60% and 36%, and at discharge in 28% and 19% of patients. During follow-up, 53 (42%) patients were hospitalized and 17 (13%) patients died. In Kaplan Meier analysis of survival curves, NT-proBNP on admission distinguished between deceased and surviving patients (p = 0.011) whilst troponin T at discharge separated hospitalized and non-hospitalized patients (p = 0.017). The adjusted Cox proportional hazard model confirmed these findings: discharge troponin T predicted hospitalisations (hazard ratio 2.89, 95% confidence interval 1.13-7.36) and admission NT-proBNP predicted mortality (hazard ratio 4.20, 95% confidence interval 1.07-14.01). Conclusions: Elevated NT-proBNP at discharge and troponin T on admission predict outcome in patients hospitalized for an acute exacerbation of COPD.

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KW - Chronic obstructive pulmonary disease

KW - Death

KW - Hospitalisation

KW - NT-proBNP

KW - Troponin

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