Background: Cardiovascular disease (CVD) is a common comorbidity in chronic obstructive pulmonary disease (COPD).\nCardiac troponin (cTn) elevation, indicating myocardial injury, is frequent during acute COPD exacerbations\nand associated with increased mortality. The prognostic value of circulating cTnT among COPD patients in\nthe stable state of the disease is still unknown.\nThe purpose of the present study was to assess the association between circulating cTnT measured by a high\nsensitive assay (hs-cTnT) and all-cause mortality among patients with stable COPD without overt CVD.\nMethods: In a prospective cohort study we included 275 patients from the Akershus University Hospitalââ?¬â?¢s outpatient\nclinic and from Glittre, a pulmonary rehabilitation clinic. COPD-severity and cardiovascular risk factors were assessed,\nand time to all-cause death was recorded during a mean follow-up time of 2.8 years.\nResults: One hundred-eighty patients (65%) had hs-cTnT concentrations ââ?°Â¥ the level of detection (5.0 ng/L) and\n66 patients (24%) had hs-cTnT above the normal range (ââ?°Â¥14.0 ng/L). In total, 47 patients (17%) died. hs-cTnT\nconcentrations in the ranges <5.0, 5.0ââ?¬â??13.9 and ââ?°Â¥14 ng/L were associated with crude mortality rates of 2.8, 4.4\nand 11.0 per 100 patient-years, respectively. In adjusted analyses the hazard ratios (95% confidence intervals) for death\nwere 1.7 (0.8ââ?¬â??3.9) and 2.9 (1.2ââ?¬â??7.2) among patients with hs-cTnT concentrations 5.0ââ?¬â??13.9 and ââ?°Â¥14 ng/L, respectively,\ncompared to patients with hs-cTnT <5.0 ng/L.\nConclusions: hs-cTnT elevation is frequently present in patients with stable COPD without overt CVD, and\nassociated with increased mortality, independently of COPD-severity and other cardiovascular risk factors.
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