Cardiac biomarkers of prognostic importance in chronic obstructive pulmonary disease
Abstract Background Ischemic heart disease is common in COPD and associated with worse prognosis. This study aimed to investigate the presence and prognostic impact of biomarkers of myocardial injury and ischemia among individuals with COPD and normal lung function, respectively. Methods In 2002–04,...
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| Format: | Article |
| Language: | English |
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BMC
2020-06-01
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| Series: | Respiratory Research |
| Subjects: | |
| Online Access: | http://link.springer.com/article/10.1186/s12931-020-01430-z |
| _version_ | 1818554692375937024 |
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| author | Ulf Nilsson Nicholas L. Mills David A. McAllister Helena Backman Caroline Stridsman Linnea Hedman Eva Rönmark Takeshi Fujisawa Anders Blomberg Anne Lindberg |
| author_facet | Ulf Nilsson Nicholas L. Mills David A. McAllister Helena Backman Caroline Stridsman Linnea Hedman Eva Rönmark Takeshi Fujisawa Anders Blomberg Anne Lindberg |
| author_sort | Ulf Nilsson |
| collection | DOAJ |
| description | Abstract Background Ischemic heart disease is common in COPD and associated with worse prognosis. This study aimed to investigate the presence and prognostic impact of biomarkers of myocardial injury and ischemia among individuals with COPD and normal lung function, respectively. Methods In 2002–04, all individuals with airway obstruction (FEV1/VC < 0.70, n = 993) were identified from population-based cohorts, together with age and sex-matched non-obstructive referents. At re-examination in 2005, spirometry, Minnesota-coded ECG and analyses of high-sensitivity cardiac troponin I (hs-cTnI) were performed in individuals with COPD (n = 601) and those with normal lung function (n = 755). Deaths were recorded until December 31st, 2010. Results Hs-cTnI concentrations were above the risk stratification threshold of ≥5 ng/L in 31.1 and 24.9% of those with COPD and normal lung function, respectively. Ischemic ECG abnormalities were present in 14.8 and 13.4%, while 7.7 and 6.6% had both elevated hs-cTnI concentrations and ischemic ECG abnormalities. The 5-year cumulative mortality was higher in those with COPD than those with normal lung function (13.6% vs. 7.7%, p < 0.001). Among individuals with COPD, elevated hs-cTnI both independently and in combination with ischemic ECG abnormalities were associated with an increased risk for death (adjusted hazard ratio [HR]; 95% confidence interval [CI] 2.72; 1.46–5.07 and 4.54; 2.25–9.13, respectively). Similar associations were observed also among individuals with COPD without reported ischemic heart disease. Conclusions In this study, elevated hs-cTnI concentrations in combination with myocardial ischemia on the electrocardiogram were associated with a more than four-fold increased risk for death in a population-based COPD-cohort, independent of disease severity. |
| first_indexed | 2024-12-12T09:43:19Z |
| format | Article |
| id | doaj.art-5ac97d9abce94f249706d15b91ab8d6b |
| institution | Directory Open Access Journal |
| issn | 1465-993X |
| language | English |
| last_indexed | 2024-12-12T09:43:19Z |
| publishDate | 2020-06-01 |
| publisher | BMC |
| record_format | Article |
| series | Respiratory Research |
| spelling | doaj.art-5ac97d9abce94f249706d15b91ab8d6b2022-12-22T00:28:30ZengBMCRespiratory Research1465-993X2020-06-0121111010.1186/s12931-020-01430-zCardiac biomarkers of prognostic importance in chronic obstructive pulmonary diseaseUlf Nilsson0Nicholas L. Mills1David A. McAllister2Helena Backman3Caroline Stridsman4Linnea Hedman5Eva Rönmark6Takeshi Fujisawa7Anders Blomberg8Anne Lindberg9Department of Public Health and Clinical Medicine, Section of Medicine, Umeå University Hospital, B41BHF Centre for Cardiovascular Science, University of EdinburghInstitute of Health and Wellbeing, University of GlasgowDepartment of Public Health and Clinical Medicine, The OLIN unit, Section of Sustainable Health, Umeå UniversityDepartment of Health Science, Division of Nursing, Luleå University of TechnologyDepartment of Public Health and Clinical Medicine, The OLIN unit, Section of Sustainable Health, Umeå UniversityDepartment of Public Health and Clinical Medicine, The OLIN unit, Section of Sustainable Health, Umeå UniversityBHF Centre for Cardiovascular Science, University of EdinburghDepartment of Public Health and Clinical Medicine, Section of Medicine, Umeå University Hospital, B41Department of Public Health and Clinical Medicine, Section of Medicine, Umeå University Hospital, B41Abstract Background Ischemic heart disease is common in COPD and associated with worse prognosis. This study aimed to investigate the presence and prognostic impact of biomarkers of myocardial injury and ischemia among individuals with COPD and normal lung function, respectively. Methods In 2002–04, all individuals with airway obstruction (FEV1/VC < 0.70, n = 993) were identified from population-based cohorts, together with age and sex-matched non-obstructive referents. At re-examination in 2005, spirometry, Minnesota-coded ECG and analyses of high-sensitivity cardiac troponin I (hs-cTnI) were performed in individuals with COPD (n = 601) and those with normal lung function (n = 755). Deaths were recorded until December 31st, 2010. Results Hs-cTnI concentrations were above the risk stratification threshold of ≥5 ng/L in 31.1 and 24.9% of those with COPD and normal lung function, respectively. Ischemic ECG abnormalities were present in 14.8 and 13.4%, while 7.7 and 6.6% had both elevated hs-cTnI concentrations and ischemic ECG abnormalities. The 5-year cumulative mortality was higher in those with COPD than those with normal lung function (13.6% vs. 7.7%, p < 0.001). Among individuals with COPD, elevated hs-cTnI both independently and in combination with ischemic ECG abnormalities were associated with an increased risk for death (adjusted hazard ratio [HR]; 95% confidence interval [CI] 2.72; 1.46–5.07 and 4.54; 2.25–9.13, respectively). Similar associations were observed also among individuals with COPD without reported ischemic heart disease. Conclusions In this study, elevated hs-cTnI concentrations in combination with myocardial ischemia on the electrocardiogram were associated with a more than four-fold increased risk for death in a population-based COPD-cohort, independent of disease severity.http://link.springer.com/article/10.1186/s12931-020-01430-zCOPDMultimorbidityMyocardial ischemiaTroponinElectrocardiographyMortality |
| spellingShingle | Ulf Nilsson Nicholas L. Mills David A. McAllister Helena Backman Caroline Stridsman Linnea Hedman Eva Rönmark Takeshi Fujisawa Anders Blomberg Anne Lindberg Cardiac biomarkers of prognostic importance in chronic obstructive pulmonary disease Respiratory Research COPD Multimorbidity Myocardial ischemia Troponin Electrocardiography Mortality |
| title | Cardiac biomarkers of prognostic importance in chronic obstructive pulmonary disease |
| title_full | Cardiac biomarkers of prognostic importance in chronic obstructive pulmonary disease |
| title_fullStr | Cardiac biomarkers of prognostic importance in chronic obstructive pulmonary disease |
| title_full_unstemmed | Cardiac biomarkers of prognostic importance in chronic obstructive pulmonary disease |
| title_short | Cardiac biomarkers of prognostic importance in chronic obstructive pulmonary disease |
| title_sort | cardiac biomarkers of prognostic importance in chronic obstructive pulmonary disease |
| topic | COPD Multimorbidity Myocardial ischemia Troponin Electrocardiography Mortality |
| url | http://link.springer.com/article/10.1186/s12931-020-01430-z |
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