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Titel: High-sensitivity troponin I and all-cause mortality in patients with stable COPD: an analysis of the COSYCONET study
VerfasserIn: Waschki, Benjamin
Alter, Peter
Zeller, Tanja
Magnussen, Christina
Neumann, Johannes T.
Twerenbold, Raphael
Sinning, Christoph
Herr, Christian
Kahnert, Kathrin
Fähndrich, Sebastian
Blankenberg, Stefan
Rabe, Klaus F.
Welte, Tobias
Jörres, Rudolf A.
Vogelmeier, Claus F.
Bals, Robert
Watz, Henrik
Sprache: Englisch
Titel: The European Respiratory Journal
Bandnummer: 55
Heft: 2
Verlag/Plattform: European Respiratory Society
Erscheinungsjahr: 2020
DDC-Sachgruppe: 610 Medizin, Gesundheit
Dokumenttyp: Journalartikel / Zeitschriftenartikel
Abstract: Chronic obstructive pulmonary disease (COPD) is a leading cause of death with a considerable part of the population dying from cardiovascular diseases. High-sensitivity troponin I (hsTnI) might help to better identify COPD patients at high risk of mortality. We aimed to study the predictive value of hs-TnI for all-cause mortality beyond established COPD assessments, and after consideration of relevant cardiovascular risk factors and prevalent cardiovascular diseases, in a broad population with stable COPD. Circulating hs-TnI concentrations together with a wide range of respiratory and cardiovascular markers were evaluated in 2085 patients with stable COPD across all severity stages enrolled in the multicentre COSYCONET cohort study. The primary outcome was all-cause mortality over 3 years of follow-up. Hs-TnI was detectable in 2020 (96.9%) patients. The median hs-TnI concentration was 3.8 ng·L−1 (interquartile range 2.5–6.6 ng·L−1 ), with levels above the 99th percentile reference limit of 27 ng·L−1 observed in 1.8% of patients. In Cox regression analyses including adjustments for airflow limitation, dyspnoea grade, exercise capacity and history of severe exacerbations, as well as traditional cardiovascular risk factors, estimated glomerular filtration rate, ankle–brachial index, N-terminal pro-brain natriuretic peptides and prevalent cardiovascular diseases, hs-TnI was a significant predictor for all-cause mortality, both as a continuous variable (hazard ratio (HR) for log hs-TnI 1.28, 95% CI 1.01–1.62) and categorised according to the cut-off of 6 ng·L−1 (HR 1.63, 95% CI 1.10–2.42). In patients with stable COPD, hs-TnI is a strong predictor of all-cause mortality beyond established COPD mortality predictors, and independent of a broad range of cardiovascular risk factors and prevalent cardiovascular diseases. Hs-TnI concentrations well below the upper reference limit provide further prognostic value for all patients with COPD when added to established risk assessments.
DOI der Erstveröffentlichung: 10.1183/13993003.01314-2019
URL der Erstveröffentlichung: https://erj.ersjournals.com/content/55/2/1901314
Link zu diesem Datensatz: urn:nbn:de:bsz:291--ds-366700
hdl:20.500.11880/33312
http://dx.doi.org/10.22028/D291-36670
ISSN: 1399-3003
0903-1936
Datum des Eintrags: 6-Jul-2022
Bezeichnung des in Beziehung stehenden Objekts: Supplementary Material
In Beziehung stehendes Objekt: https://erj.ersjournals.com/content/erj/55/2/1901314/DC1/embed/inline-supplementary-material-1.pdf?download=true
https://erj.ersjournals.com/content/erj/55/2/1901314/DC2/embed/inline-supplementary-material-2.pdf?download=true
Fakultät: M - Medizinische Fakultät
Fachrichtung: M - Innere Medizin
Professur: M - Prof. Dr. Robert Bals
Sammlung:SciDok - Der Wissenschaftsserver der Universität des Saarlandes

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