Abstract
Background: Cardiovascular (CV) disease is a frequent comorbidity and a major cause of death in COPD. Very low circulating levels of high-sensitivity troponin I (hs-TnI) predict CV events and all-cause mortality in the general population beyond established risk factors. The aim of this study was to evaluate hs-TnI levels and its predictive value for all-cause mortality in stable COPD.
Methods: In the multicenter COSYCONET cohort study enrolling stable COPD patients (GOLD stage I-IV), hs-TnI was measured in serum samples collected at the baseline visit using a hs-TnI Assay (Abbott Diagnostics) with a lower limit of detection (LoD) of 1.9 ng/L. Cox regression analyses were used to evaluate the incremental predictive value of hs-TnI for all-cause mortality compared to established risk factors.
Results: Among 2045 COPD patients, hs-TnI concentrations were above the LoD in 87.2% (n=1783). The median hs-TnI level was 3.8 ng/L (IQR, 2.5‒6.6 ng/L). 595 patients (28.5%) had elevated hs-TnI levels according to the previously described cut-off value to identify individuals at high risk for CV events and death (i.e. 6 ng/L). No significant association was observed between hs-TnI and airflow limitation. During a median follow-up time of 3.1 years, 185 patients (9.0%) died. An elevated hs-TnI level independently predicted all-cause mortality even after adjustment for CV risk factors (HR 1.39, 95% CI 1.03‒1.89, p=0.034) and for the components of the BODE score, i.e. BMI, FEV1, mMRC dyspnoe scale, and 6MWD, (HR 1.67, 95% CI 1.21‒2.29, p=0.002).
Conclusions: High-sensitivity troponin I levels independently predict all-cause mortality in stable patients with COPD beyond well-established prognostic indicators.
Footnotes
Cite this article as: European Respiratory Journal 2018 52: Suppl. 62, OA2138.
This is an ERS International Congress abstract. No full-text version is available. Further material to accompany this abstract may be available at www.ers-education.org (ERS member access only).
- Copyright ©the authors 2018