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Invasive coronary angiography in patients with acute exacerbated COPD and elevated plasma troponin.
Int J Chron Obstruct Pulmon Dis. 2016; 11:2081-2089.IJ

Abstract

BACKGROUND

In acute exacerbation of COPD, increased plasma levels of cardiac troponin are frequent and associated with increased mortality. Thus, we aimed at prospectively determining the diagnostic value of coronary angiography in patients with exacerbated COPD and concomitantly elevated cardiac troponin.

PATIENTS AND METHODS

A total of 88 patients (mean age 72.9±9.2 years, 56.8% male) hospitalized for acute exacerbation of COPD with elevated plasma troponin were included. All patients underwent coronary angiography within 72 hours after hospitalization. Complementary 12-lead electrocardiogram, transthoracic echocardiography, pulmonary function, and angiological testing were performed.

RESULTS

Coronary angiography objectified the presence of ischemic heart disease (IHD) in 59 patients (67.0%), of whom 34 patients (38.6% of total study population) underwent percutaneous coronary intervention. Among these 34 intervened patients, the vast majority (n=26, 76.5%) had no previously known IHD, whereas only eight out of 34 patients (23.5%) presented an IHD history. Patients requiring coronary intervention showed significantly reduced left ventricular ejection fraction (45.8%±13.1% vs 55.1%±13.3%, P=0.01) and a significantly more frequent electrocardiographic ST-segment depression (20.6% vs 7.4%, P=0.01). Neither additional laboratory parameters for inflammation and myocardial injury nor lung functional measurements differed significantly between the groups.

CONCLUSION

Angiographically confirmed IHD that required revascularization occurred in 38.6% of exacerbated COPD patients with elevated cardiac troponin. In this considerable portion of patients, coronary angiography emerged to be of diagnostic and therapeutic value.

Authors+Show Affiliations

Department of Internal Medicine II - Cardiology, Pneumology and Angiology, University Hospital Bonn, Bonn, Germany.Department of Internal Medicine II - Cardiology, Pneumology and Angiology, University Hospital Bonn, Bonn, Germany.Department of Pneumology, Johanniter Hospital Bonn, Bonn, Germany.Department of Pneumology, Malteser Hospital Bonn/Rhein-Sieg, Bonn, Germany.Department of Internal Medicine II - Cardiology, Pneumology and Angiology, University Hospital Bonn, Bonn, Germany.Department of Internal Medicine II - Cardiology, Pneumology and Angiology, University Hospital Bonn, Bonn, Germany.Department of Internal Medicine II - Cardiology, Pneumology and Angiology, University Hospital Bonn, Bonn, Germany.Department of Internal Medicine II - Cardiology, Pneumology and Angiology, University Hospital Bonn, Bonn, Germany.Department of Internal Medicine II - Cardiology, Pneumology and Angiology, University Hospital Bonn, Bonn, Germany.

Pub Type(s)

Journal Article
Multicenter Study

Language

eng

PubMed ID

27695304

Citation

Pizarro, Carmen, et al. "Invasive Coronary Angiography in Patients With Acute Exacerbated COPD and Elevated Plasma Troponin." International Journal of Chronic Obstructive Pulmonary Disease, vol. 11, 2016, pp. 2081-2089.
Pizarro C, Herweg-Steffens N, Buchenroth M, et al. Invasive coronary angiography in patients with acute exacerbated COPD and elevated plasma troponin. Int J Chron Obstruct Pulmon Dis. 2016;11:2081-2089.
Pizarro, C., Herweg-Steffens, N., Buchenroth, M., Schulte, W., Schaefer, C., Hammerstingl, C., Werner, N., Nickenig, G., & Skowasch, D. (2016). Invasive coronary angiography in patients with acute exacerbated COPD and elevated plasma troponin. International Journal of Chronic Obstructive Pulmonary Disease, 11, 2081-2089.
Pizarro C, et al. Invasive Coronary Angiography in Patients With Acute Exacerbated COPD and Elevated Plasma Troponin. Int J Chron Obstruct Pulmon Dis. 2016;11:2081-2089. PubMed PMID: 27695304.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Invasive coronary angiography in patients with acute exacerbated COPD and elevated plasma troponin. AU - Pizarro,Carmen, AU - Herweg-Steffens,Neele, AU - Buchenroth,Martin, AU - Schulte,Wolfgang, AU - Schaefer,Christian, AU - Hammerstingl,Christoph, AU - Werner,Nikos, AU - Nickenig,Georg, AU - Skowasch,Dirk, Y1 - 2016/09/16/ PY - 2016/10/4/entrez PY - 2016/10/4/pubmed PY - 2017/8/10/medline KW - COPD KW - acute exacerbation KW - coronary angiography KW - ischemic heart disease KW - troponin elevation SP - 2081 EP - 2089 JF - International journal of chronic obstructive pulmonary disease JO - Int J Chron Obstruct Pulmon Dis VL - 11 N2 - BACKGROUND: In acute exacerbation of COPD, increased plasma levels of cardiac troponin are frequent and associated with increased mortality. Thus, we aimed at prospectively determining the diagnostic value of coronary angiography in patients with exacerbated COPD and concomitantly elevated cardiac troponin. PATIENTS AND METHODS: A total of 88 patients (mean age 72.9±9.2 years, 56.8% male) hospitalized for acute exacerbation of COPD with elevated plasma troponin were included. All patients underwent coronary angiography within 72 hours after hospitalization. Complementary 12-lead electrocardiogram, transthoracic echocardiography, pulmonary function, and angiological testing were performed. RESULTS: Coronary angiography objectified the presence of ischemic heart disease (IHD) in 59 patients (67.0%), of whom 34 patients (38.6% of total study population) underwent percutaneous coronary intervention. Among these 34 intervened patients, the vast majority (n=26, 76.5%) had no previously known IHD, whereas only eight out of 34 patients (23.5%) presented an IHD history. Patients requiring coronary intervention showed significantly reduced left ventricular ejection fraction (45.8%±13.1% vs 55.1%±13.3%, P=0.01) and a significantly more frequent electrocardiographic ST-segment depression (20.6% vs 7.4%, P=0.01). Neither additional laboratory parameters for inflammation and myocardial injury nor lung functional measurements differed significantly between the groups. CONCLUSION: Angiographically confirmed IHD that required revascularization occurred in 38.6% of exacerbated COPD patients with elevated cardiac troponin. In this considerable portion of patients, coronary angiography emerged to be of diagnostic and therapeutic value. SN - 1178-2005 UR - https://www.unboundmedicine.com/medline/citation/27695304/Invasive_coronary_angiography_in_patients_with_acute_exacerbated_COPD_and_elevated_plasma_troponin_ L2 - https://dx.doi.org/10.2147/COPD.S110746 DB - PRIME DP - Unbound Medicine ER -