Cardiac biomarkers of prognostic importance in chronic obstructive pulmonary disease

Nilsson, U., Mills, N. L., McAllister, D. A. , Backman, H., Stridsman, C., Hedman, L., Rönmark, E., Fujisawa, T., Blomberg, A. and Lindberg, A. (2020) Cardiac biomarkers of prognostic importance in chronic obstructive pulmonary disease. Respiratory Research, 21, 162. (doi: 10.1186/s12931-020-01430-z) (PMID:32590988) (PMCID:PMC7318493)

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.

• Item Type: Articles
• Additional Information: Funding for this project was received from The Swedish Heart and Lung foundation, the VisareNorr Fund/Northern County Council’s Regional Federation, the Swedish Heart and Lung Association, the County Council of Norrbotten, the Swedish Respiratory Society, the County Council of Västerbotten (ALF), King Gustaf V and Queen Victoria’s Freemason Foundation and Umeå University, Sweden. This work was also supported by the British Heart Foundation [Butler Senior Clinical Research Fellowship FS/16/14/32023] to N.L.M. Open access funding provided by Umea University.
• Status: Published
• Refereed: Yes
• Glasgow Author(s) Enlighten ID: McAllister, Professor David
• Authors: Nilsson, U., Mills, N. L., McAllister, D. A., Backman, H., Stridsman, C., Hedman, L., Rönmark, E., Fujisawa, T., Blomberg, A., and Lindberg, A.
• College/School: College of Medical Veterinary and Life Sciences > School of Health & Wellbeing > Public Health
• Journal Name: Respiratory Research
• Publisher: BioMed Central
• ISSN: 1465-9921
• ISSN (Online): 1465-993X
• Copyright Holders: Copyright © 2020 The Authors
• First Published: First published in Respiratory Research 21: 162
• Publisher Policy: Reproduced under a Creative Commons License