Elevated Troponin Levels may predict mortality among patients with COPD Exacerbations

Chronic Obstructive Pulmonary Disease (COPD) patients facing exacerbations may now have a potential predictive marker for major adverse cardiac events (MACE), according to a recent study conducted across five hospitals in England. While no singular biomarker currently exists for risk stratification during COPD exacerbation, this research focused on the correlation between elevated troponin levels and subsequent adverse outcomes.

Troponin, a cardiac marker, was found to be elevated in 44.5% of the 2487 COPD patients analyzed. Among these individuals, 22.8% experienced a MACE event, and 9.0% were readmitted for COPD within 90 days from peak troponin measurement. The study adjusted for various factors, including age, sex, laboratory results, and clinical risk factors.

Patients with troponin levels exceeding the upper limit of normal demonstrated a significantly higher risk of MACE (adjusted HR 2.20, 95% CI 1.75–2.77) and COPD hospital readmission (adjusted HR 1.37, 95% CI 1.02–1.83) compared to those without elevated troponin. The findings suggest that an elevated troponin level during a COPD exacerbation could serve as a valuable tool for predicting cardiovascular events in COPD patients.

The research underscores the importance of exploring new markers for risk stratification during COPD exacerbation, particularly given the complexity of the disease and its diverse outcomes. While this study provides crucial insights into the potential link between troponin levels and cardiovascular risks, further investigations are needed to understand the nuanced relationship between the degree of troponin elevation and the likelihood of future adverse events. This development opens avenues for enhanced monitoring and tailored interventions for COPD patients, offering a glimpse into a more personalized approach to managing exacerbations and improving overall patient outcomes.

Reference:

Kallis, C., Kaura, A., Samuel, N., Mulla, A., Glampson, B., O’Gallagher, K., Davies, J., Papadimitriou, D., Woods, K., Shah, A., Williams, B., Squire, I., Johnson, T., … Quint, J. (2023). The Relationship Between Cardiac Troponin in People Hospitalised for Exacerbation of COPD and Major Adverse Cardiac Events (MACE) and COPD Readmissions. In International Journal of Chronic Obstructive Pulmonary Disease: Vol. Volume 18 (pp. 2405–2416). Informa UK Limited. https://doi.org/10.2147/copd.s432166