Invasive coronary angiography in patients with acute exacerbated COPD and elevated plasma troponin
| Autor: | Carmen Pizarro, Neele Herweg-Steffens, Dirk Skowasch, Wolfgang Schulte, Christoph Hammerstingl, Martin Buchenroth, Nikos Werner, Christian Schaefer, Georg Nickenig |
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| Rok vydání: | 2016 |
| Předmět: |
Male
Exacerbation medicine.medical_treatment Coronary Artery Disease 030204 cardiovascular system & hematology Coronary Angiography Severity of Illness Index Pulmonary function testing Electrocardiography Pulmonary Disease Chronic Obstructive 0302 clinical medicine troponin elevation Forced Expiratory Volume Germany Prospective Studies Lung Depression (differential diagnoses) Original Research Aged 80 and over COPD Ejection fraction biology General Medicine Middle Aged Up-Regulation Hospitalization Echocardiography Disease Progression Cardiology Female medicine.medical_specialty International Journal of Chronic Obstructive Pulmonary Disease Revascularization 03 medical and health sciences Percutaneous Coronary Intervention Predictive Value of Tests Internal medicine medicine Humans acute exacerbation Aged Plethysmography Whole Body business.industry Troponin I Coronary Stenosis Percutaneous coronary intervention medicine.disease ischemic heart disease Troponin 030228 respiratory system Spirometry biology.protein business Biomarkers |
| Zdroj: | International Journal of Chronic Obstructive Pulmonary Disease |
| ISSN: | 1178-2005 |
| Popis: | Carmen Pizarro,1,* Neele Herweg-Steffens,1,* Martin Buchenroth,2 Wolfgang Schulte,3 Christian Schaefer,1 Christoph Hammerstingl,1 Nikos Werner,1 Georg Nickenig,1 Dirk Skowasch1 1Department of Internal Medicine II – Cardiology, Pneumology and Angiology, University Hospital Bonn, Germany; 2Department of Pneumology, Johanniter Hospital Bonn, Germany; 3Department of Pneumology, Malteser Hospital Bonn/Rhein-Sieg, Germany *These authors contributed equally to this work 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±9.2years, 56.8% male) hospitalized for acute exacerbation of COPD with elevated plasma troponin were included. All patients underwent coronary angiography within 72hours 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.Keywords: COPD, acute exacerbation, troponin elevation, coronary angiography, ischemic heart disease |
| Databáze: | OpenAIRE |
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