COHgb levels predict the long-term development of acute myocardial infarction in CO poisoning
Related Experiment Video
Updated: Mar 24, 2026
Cutoff Value of Phase Angle by Bioelectrical Impedance Analysis at Admission as a Prognostic Factor in Patients with Acute Heart Failure
Published on: June 10, 2025
Hakki Kaya1, Abuzer Coşkun2, Osman Beton1
1Department of Cardiology, Cumhuriyet University Medical School, Sivas, Turkey.
Insights
High carboxyhemoglobin (COHb) levels after carbon monoxide (CO) poisoning predict long-term acute myocardial infarction (AMI) risk. Elevated COHb levels can help stratify patients for long-term AMI development after CO poisoning.
Area of Science:
- Cardiology
- Toxicology
- Epidemiology
Background:
- Limited research exists on long-term cardiac effects of carbon monoxide (CO) poisoning.
- Studies primarily focus on acute cardiac effects, necessitating investigation into chronic outcomes.
Purpose of the Study:
- To evaluate the association between blood carboxyhemoglobin (COHb) levels and the long-term risk of acute myocardial infarction (AMI) following CO poisoning.
- To determine if initial COHb levels can predict future cardiac events.
Main Methods:
- A cross-sectional cohort study of 1013 patients with CO poisoning was conducted.
- Patients were followed for an average of 56 months to track AMI development.
- Diagnosis of CO poisoning required a COHb level >5%.
Main Results:
- 10% of patients developed AMI during follow-up.
- Higher initial COHb levels were significantly associated with AMI development (55%±6% vs 30%±7%, P<.001).
- Age, COHb level, CO exposure time, and smoking were independent predictors of AMI risk. A COHb cutoff of >45% predicted AMI with 98% sensitivity and 94.1% specificity.
Conclusions:
- Blood carboxyhemoglobin levels are valuable for stratifying long-term AMI risk in patients with CO poisoning.
- Higher COHb levels indicate a greater risk for developing AMI post-poisoning.
Background:
There are several studies evaluating the cardiac effects of carbon monoxide (CO) poisoning during the acute period; however, the number of studies evaluating the long-term cardiac effects is limited.
Objective:
The present study aimed to evaluate the effects of blood carboxyhemoglobin (COHb) levels, elevated due to CO poisoning on the long-term development of acute myocardial infarction (AMI).
Methods:
This cross-sectional cohort study included a total of 1013 consecutive patients who presented to the emergency department (ED) due to CO poisoning, between January 2005 and December 2007. The diagnosis of CO poisoning was made according to the medical history and a COHb level of greater than 5%. In terms of AMI development, the patients were followed up for an average of 56 months.
Results:
At the end of follow-up, 100 (10%) of 1013 patients experienced AMI. Carboxyhemoglobin levels at the time of poisoning were higher among those who were diagnosed with AMI compared to those who were not (55%±6% vs 30%±7%; P<.001). Using a multivariate Cox proportional hazards model with forward stepwise method, age, COHb level, CO exposure time, and smoking remained associated with an increased risk of AMI after adjustment for the variables found to be statistically significant in a univariate analysis. According to a receiver operating characteristic curve analysis, the optimal cutoff value of COHb used to predict the development of AMI was found to be greater than 45%, with 98% sensitivity and 94.1% specificity.
Conclusion:
In patients presenting to the ED with CO poisoning, COHb levels can be helpful for risk stratification in the long-term development of AMI.
More Related Videos
Related Concept Videos
01:20Blood Studies for Cardiovascular System I: Cardiac Biomarkers
The essential diagnostic tools for detecting myocardial necrosis and monitoring individuals suspected of having acute coronary syndrome (ACS) include:
Troponins
Troponins, particularly cardiac troponins I and T, are the most precise and sensitive markers of myocardial injury. They are detectable within 4-6 hours of myocardial injury and remain...
01:30Acute Coronary Syndrome III: Diagnostic Studies
01:19Acute Coronary Syndrome II: Pathophysiology and Clinical Manifestations
01:19Blood Studies for Cardiovascular System II: CRP, Hcy, and Cardiac Natriuretic Peptide Markers
These markers indicate stress or strain on the heart muscle:
Natriuretic Peptides (BNP)
Cardiac myocytes produce these hormones in response to ventricular stretching...
01:30Acute Coronary Syndrome I: Introduction
01:29Cardiomyopathy III: Hypertrophic Cardiomyopathy