Cardiac biomarkers predict outcome after hospitalisation for an acute exacerbation of chronic obstructive pulmonary disease

Int J Cardiol. 2012 Nov 29;161(3):156-9. doi: 10.1016/j.ijcard.2012.05.044. Epub 2012 Jun 4.


Purpose: In chronic obstructive pulmonary disease (COPD), cardiovascular system is involved but less is known about role of specific cardiac biomarkers. We aimed to investigate associations between N-terminal pro B-type natriuretic peptide (NT-proBNP) and troponin T during hospitalisation with 6-month outcome.

Methods: This was a prospective study conducted in consecutive patients hospitalized for an acute exacerbation of COPD. On admission, and at discharge, NT-proBNP and troponin T were measured, and echocardiography was performed. Hospitalisations and mortality were recorded for 6 months after discharge.

Results: We included 127 patients (70 ± 10 years, 70% men, GOLD III/IV 87%). Left ventricular dysfunction was detected in 70 (55%) patients and diastolic dysfunction was the most common type (53 patients-42%). NT-proBNP and troponin T were elevated on admission in 60% and 36%, and at discharge in 28% and 19% of patients. During follow-up, 53 (42%) patients were hospitalized and 17 (13%) patients died. In Kaplan Meier analysis of survival curves, NT-proBNP on admission distinguished between deceased and surviving patients (p=0.011) whilst troponin T at discharge separated hospitalized and non-hospitalized patients (p=0.017). The adjusted Cox proportional hazard model confirmed these findings: discharge troponin T predicted hospitalisations (hazard ratio 2.89, 95% confidence interval 1.13-7.36) and admission NT-proBNP predicted mortality (hazard ratio 4.20, 95% confidence interval 1.07-14.01).

Conclusions: Elevated NT-proBNP at discharge and troponin T on admission predict outcome in patients hospitalized for an acute exacerbation of COPD.

Publication types

  • Randomized Controlled Trial

MeSH terms

  • Acute Disease
  • Aged
  • Aged, 80 and over
  • Biomarkers / blood
  • Female
  • Heart Diseases / blood*
  • Heart Diseases / diagnosis*
  • Heart Diseases / epidemiology
  • Hospitalization / trends*
  • Humans
  • Male
  • Middle Aged
  • Predictive Value of Tests
  • Prospective Studies
  • Pulmonary Disease, Chronic Obstructive / blood*
  • Pulmonary Disease, Chronic Obstructive / diagnosis*
  • Pulmonary Disease, Chronic Obstructive / epidemiology
  • Treatment Outcome


  • Biomarkers