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Conventional vs high-sensitive troponins in acute exacerbations of chronic obstructive pulmonary disease

Huiying Xu1, Joo Hor Tan2, John Arputhan Abisheganaden1

  • 1Department of Respiratory and Critical Care Medicine, Tan Tock Seng Hospital, 11 Jln Tan Tock Seng, Singapore 308433, Singapore.

Heart & Lung : the Journal of Critical Care
|February 23, 2021
PubMed

Insights

Predictors for abnormal cardiac troponin (cTn) levels differ between conventional and high-sensitive assays during acute exacerbations of chronic obstructive pulmonary disease (AECOPD). Interpretation of cTn results in AECOPD requires consideration of these assay-specific factors.

Area of Science:

  • Cardiology
  • Pulmonology
  • Clinical Chemistry

Background:

  • Cardiac troponins (cTn), both conventional and high-sensitive (hscTn) assays, are frequently utilized during acute exacerbations of chronic obstructive pulmonary disease (AECOPD).
  • Understanding factors influencing abnormal cTn levels is crucial for accurate diagnosis and patient management in this clinical setting.

Purpose of the Study:

  • To compare the factors that predict abnormal results for conventional cTn assays versus hscTn assays in patients presenting with AECOPD.
  • To identify specific clinical and biochemical predictors that differentiate between the two troponin assay types.

Main Methods:

  • A retrospective study analyzed data from AECOPD patients who underwent either conventional or hscTn testing.
  • Binary logistic regression was employed to identify significant predictors for elevated conventional cTn (>0.5 µg/L) and hscTn (>40 ng/L).

Main Results:

  • The study included 466 patients in the conventional cTn group and 313 in the hscTn group.
  • Ischemic electrocardiographic changes were the sole significant predictor for abnormal conventional cTn (OR 6.662, p=0.028).
  • B-type natriuretic peptide levels (Adj OR 1.004, p=0.010) and SpO2/FiO2 ratio (Adj OR 0.115, p=0.026) significantly predicted abnormal hscTn.

Conclusions:

  • The predictors for abnormal cardiac troponin levels vary significantly between conventional and high-sensitive assays.
  • These assay-specific differences must be considered when interpreting cTn results in the context of AECOPD to avoid misdiagnosis.
Abstract

Keywords:
Acute exacerbationB-type natriuretic peptideChronic obstructive lung diseaseMyocardial infarctionRight ventricular strainTroponin

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