Diagnosis of myocardial infarction following hospitalisation for exacerbation of COPD

McAllister, D. A. et al. (2012) Diagnosis of myocardial infarction following hospitalisation for exacerbation of COPD. European Respiratory Journal, 39(5), pp. 1097-1103. (doi: 10.1183/09031936.00124811) (PMID:22323574)

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Abstract

Cardiovascular disease is common in chronic obstructive pulmonary disease (COPD) and raised troponin is common in exacerbations. However, the prevalence of myocardial infarction following hospitalisation for exacerbation of COPD is unknown. Patients aged ≥40 yrs hospitalised with acute exacerbation of COPD (n=242) with ≥10 pack-yrs of cigarette smoking were included in a prospective case series conducted in four hospitals. Patients whose primary presenting complaint was chest pain or who had an alternative diagnosis were excluded. Chest pain histories, serial ECGs and troponin levels were obtained. The mean±sd age was 69±9 yrs; 108 (45%) patients were male and almost half were current smokers. 124 (51%; 95% CI 48–58%) patients had chest pain, which was exertional in 62 (26%). 24 (10%) had raised troponin, among whom, 20 (8.3%; 95% CI 5.1–12.5%) had chest pain and/or serial ECG changes, fulfilling the 2007 Universal Definition of Myocardial Infarction. Neither chest pain (p=0.77) nor serial ECG changes (p=0.39) were associated with raised troponin. Raised troponin, chest pain and serial ECG changes are common in patients admitted to hospital with exacerbation of COPD. Overall, one in 12 patients met the criteria for myocardial infarction. Whether these patients would benefit from further cardiac investigation is unknown.

Item Type:Articles
Status:Published
Refereed:Yes
Glasgow Author(s) Enlighten ID:McAllister, Professor David
Authors: McAllister, D. A., Maclay, J. D., Mills, N. L., Leitch, A., Reid, P., Carruthers, R., O’Connor, J., McAlpine, L., Chalmers, G., Newby, D. E., Clark, E., Macfarlane, P. W., and MacNee, W.
College/School:College of Medical Veterinary and Life Sciences > School of Health & Wellbeing > Public Health
Journal Name:European Respiratory Journal
Publisher:European Respiratory Society
ISSN:0903-1936
ISSN (Online):1399-3003
Published Online:30 April 2012

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