Troponin T elevation and long-term mortality after chronic obstructive pulmonary disease exacerbation

Brekke, P.; Omland, Torbjørn; Holmedal, Stein Harald; Smith, Pål; Søyseth, Vidar

doi:10.1183/09031936.00015807

Cited by 89 publications

(90 citation statements)

References 29 publications

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“…Obecność chorób sercowo-naczyniowych może przedłużać toczące się zaostrzenie POChP oraz nasilać przewlekły, ogólnoustrojowy proces zapalny [14]. Wykazano, że podwyższone stężenie troponin w czasie za-www.pneumonologia.viamedica.pl ostrzenia POChP może odzwierciedlać ciężkość jego przebiegu oraz wskazywać na zwiększone ryzyko zgonu po okresie hospitalizacji [15]. Prospektywne badania potwierdziły, że zwiększone stężenia zarówno NT-proBNP, jak i troponiny T u pacjentów hospitalizowanych z powodu zaostrzenia POChP, są związane ze zwiększoną śmiertelnością, niezależnie od innych czynników prognostycznych [16,17].…”

Section: Choroby Sercowo-naczyniowe a Pochpunclassified

Przewlekła Obturacyjna Choroba Płuc i Choroby Sercowo-Naczyniowe—“Kontinuum Sercowo-PłUcne”

Batura‐Gabryel¹,

Grabicki²

2014

Advances in Respiratory Medicine

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Przewlekła obturacyjna choroba płuc i choroby sercowo--naczyniowe -"kontinuum sercowo-płucne"Chronic obstructive pulmonary disease and cardiovascular diseases -'cardiopulmonary continuum' Praca nie była finansowana AbstractChronic obstructive pulmonary disease (COPD) is characterised by persistent airflow limitation and extrapulmonary comorbidities, which contribute to the overall severity. Some risk factors, with tobacco smoking as the most serious one, lead to a chronic, systemic inflammation that plays the main role in the pathogenesis of COPD and comorbidities, including cardiovascular diseases (CVD). The course of COPD is diverse; it depends on pathologies in the respiratory system and on other organ dysfunctions. CVDs are the most commonly recognised comorbidities in COPD patients. The severity and natural course of COPD, as well as quality of the patient's life, are influenced by them. CVDs are frequently the reason for hospitalisation and may lead to death. They are also an important prognostic factor. Comorbidities may prolong exacerbation of COPD. On the other hand, COPD is an independent risk factor of CVD. The prevalence of COPD is high in patients suffering from coronary artery disease, and airflow limitation is a major risk factor for chronic heart failure. These complex interactions between heart and lung can be denoted as 'cardiopulmonary continuum'. These dependencies are not recognised in detail. Currently research is being done, which attempts to explain these complicated relations. For many years COPD and CVD were not connected. Today it is known that patients suffering from COPD must be provided comprehensive care. It is necessary to monitor the risk of CVD and their influence on the COPD course. Careful and proper treatment of all diseases is essential. An interdisciplinary team with good cooperation should prepare a plan of COPD treatment with simultaneous therapy of comorbidities. Key words: COPD, cardiovascular diseases, comorbiditiesPneumonol. Alergol. Pol. 2014; 82: 590-596 StreszczeniePrzebieg przewlekłej obturacyjnej choroby płuc (POChP) charakteryzuje się nie tylko utrzymującymi się ograniczeniami przepływu powietrza przez oskrzela, ale również współwystępowaniem patologii pozapłucnych. Czynniki ryzyka, w tym przede wszystkim palenie tytoniu, prowadzą do rozwoju przewlekłego, ogólnoustrojowego procesu zapalnego, który pełni główną rolę w patogenezie zarówno POChP, jak i wielu chorób towarzyszących, w tym sercowo-naczyniowych. Obraz kliniczny POChP jest różnorodny i zależy od nasilenia zmian w układzie oddechowym, jak również od dysfunkcji innych narządów i chorób współistniejących. U osób z chorobą obturacyjną płuc najczęściej obserwuje się współwystępowanie chorób układu sercowo-naczyniowego, które wpływają na jej ciężkość i przebieg naturalny, na jakość życia chorych oraz wielokrotnie są przyczyną hospitalizacji i zgonu. Są również ważnym czynnikiem prognostycznym. Obecność dodatkowych chorób może przedłużać zaostrzenie POChP. Z drugiej strony POChP jest niezależnym czynnikiem ryz...

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Section: Choroby Sercowo-naczyniowe a Pochpunclassified

Przewlekła Obturacyjna Choroba Płuc i Choroby Sercowo-Naczyniowe—“Kontinuum Sercowo-PłUcne”

Batura‐Gabryel¹,

Grabicki²

2014

Advances in Respiratory Medicine

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“…Bazı çalımalar hastanede kalış süresinin troponin yüksekliği ile ilişkili olduğunu ifade etmektedir (9,(11)(12)(13). Çalışmalarında KOAH hastalarında troponin artışının KOAH alevlenmesinin ciddiyetini gös-terebileceğini, hastanede bu grubun daha uzun süre kaldığını bulmuşlardı.…”

Section: Discussionunclassified

“…Buda istatistiksel olarak KOAH hastalarında troponini bir mortalite prediktörü gibi gösterebilir. Bazı çalışmalar KOAH akut atağında gözlenen troponin artışının ko-morbid hastalıkların sonucu olduğunu ve uzun dönem mortalitenin prediktörü olduğunu ifade etmiştir (12,13). Bizim çalışmamızda çalışma dışı bırakılma kriterleri titizlikle uygulanmıştır.…”

Section: Discussionunclassified

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Elevated Troponin Levels in Acute Exacerbation of COPD

Erdogan¹,

Güloǧlu²,

Orak³

et al. 2013

JAEM

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Objective: To investigate the correlation between serum troponin elevation and vital signs, arterial blood gases, length of stay, prognosis in patients admitted to the emergency department with an exacerbation of chronic obstructive pulmonary disease. Material and Methods: This prospective study was performed on 100 COPD patients admitted to the Dicle University Hospital Emergency Department between January 2008 and June 2008. Ki square test was used for univariate analyses of categorical variables, Mann-Whitney U Test was used for continuous variables. Results: In our study, 11% of patients were in the elevated sTnI group. Elevation of sTnI had no statistical relation with vital signs, electrocardiographic datas or arterial blood gases. Elevation of sTnI had no statistical relation with length of stay (p=0.863), ICU admission (p=0.619) or mortality (p=0.061). Conclusion: High sTnI in COPD patients has no predictive value for length of stay, ICU admission and prognosis. (JAEM 2013; 12: 130- GirişTroponinler, kreatin kinaz(CK) ve kreatin kinaz-MB' ye (CK-MB) göre miyokardiyal nekrozu göstermede oldukça spesifik belirleyicilerdir (1-3). Kardiyak troponin düzeylerinin pulmoner emboli, ciddi konjestif kalp yetmezliği, direkt kardiyak yaralanma, elektrik çarpma-sı, toksin etkisi (adriamycin, 5-fluorouracil, trastuzumab, yılan zehiri), viral miyokardit, perikardit, serebrovasküler olay, sepsis, taşiaritmiler ve lober pnömoni gibi non-iskemik durumlarda, kronik obstrüktif akciğer hastalıklı (KOAH) olgularda da yükseldiği bildirilmiştir (4, 5). KOAH endüstriyel topluluklarda hala artmakta olan yegane mortalite nedenidir. Yavaş seyri, sürekli kötüleşen atakları, yatış ihtiyacı ve mortalitesiyle KOAH bir halk sağlığı sorunudur (1, 6).Çalışmamızda, akut dönemdeki KOAH'lı olgularda serum troponin I (sTnI) düzeylerinin vital bulgular, arteriyel kan gazları (AKG) rutin biyokimyasal tetkikler hastanede kalış, prognoz ve mortalite ile ilişki-sinin araştırılması amaçlanmıştır.

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“…[15][16][17][18] Detection of pathologic levels of inflammatory biomarkers improves the ability to predict the mortality risk in COPD alongside with the BODE index (BMI, obstruction in lung function, dyspnea scale, 6-minute walk test) and may provide a targeted treatment. 19,20 roLE oF dEtEctInG BIoMArKErS In coPd Although biomarker evaluation in COPD is particularly promising, at the moment there isn't any absolutely specific and sufficiently sensitive biomarker to predict the progression of the disease, the occurrence of exacerbations, the evolution under treatment or the mortality risk. 12,14 Markers that have been designated as potential indicators for increased risk of developing COPD in smokers or subjects exposed to hazards and the exacerbation can be determined from different samples:…”

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confidence: 99%

Inflammatory Biomarkers in Chronic Obstructive Pulmonary Disease

Comes

Ianoși

Jimborean

2016

Journal of Interdisciplinary Medicine

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Chronic obstructive lung disease (COPD) is a severe progressive disease associated with high morbidity and mortality. Early diagnosis and correct treatment improve the symptoms, quality of life and survival in COPD. Exacerbations of the disease are acute events that cause worsening of COPD symptoms (dyspnea, cough and/or sputum) and may require modification of stable COPD therapy. COPD exacerbations add inflammation, damage the quality of life, deteriorate the lung function, increase mortality and associate high socio-economic costs. Accurate early prediction of exacerbation and mortality risk facilitates patient selection upon risk, in order to provide appropriately targeted early treatment. The risk of having frequent exacerbations is clearly demonstrated by recognized studies in patients with specific criteria: previous exacerbation in the last year, decrease in FEV1s, increase in the score of St. George Questionnaire (life quality decline), high levels of several inflammatory biomarkers, such as neutrophils, C-reactive protein (CRP), fibrinogen, pro-calcitonin, eosinophils, IL-6, IL-8, chemokine ligand 18 (CCL-18/PARC), surfactant protein D (SP-D). Simultaneously elevated levels of CRP, fibrinogen and leukocyte count in COPD patients were associated with an increased risk for exacerbations. At the same time, elevated levels of the three biomarkers are associated with an increased risk of major comorbidities in COPD. Biomarker detection may be an additional tool for assessment and management of COPD comorbidities. Detection of pathologic levels of inflammatory biomarkers improves the ability to predict the risk mortality in COPD alongside with BODE index (BMI, obstruction in lung function, dyspnea scale, 6-minute walk test) and may provide a targeted treatment.

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Troponin T elevation and long-term mortality after chronic obstructive pulmonary disease exacerbation

Cited by 89 publications

References 29 publications

Przewlekła Obturacyjna Choroba Płuc i Choroby Sercowo-Naczyniowe—“Kontinuum Sercowo-PłUcne”

Przewlekła Obturacyjna Choroba Płuc i Choroby Sercowo-Naczyniowe—“Kontinuum Sercowo-PłUcne”

Elevated Troponin Levels in Acute Exacerbation of COPD

Inflammatory Biomarkers in Chronic Obstructive Pulmonary Disease

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