Assessment of Cardiac Troponin-T in Acute Exacerbation of Chronic Obstructive Pulmonary Disease (COPD), and Its Correlation with Severity

Background: Chronic Obstructive Pulmonary Disease (COPD) is a major global health issue, recognized as the third leading cause of death worldwide. It imposes significant economic and social burdens, with rising mortality rates in industrialized nations. Acute exacerbations of COPD (AECOPD) are critical events that worsen patient outcomes and are associated with increased cardiovascular risks, including elevated cardiac Troponin-T levels. Objectives: This study aims to determine the levels of cardiac Troponin-T in patients experiencing acute exacerbations of COPD and to investigate the correlation between Troponin-T levels and the severity of these exacerbations. Methodology: A hospital-based cross-sectional study was conducted at the National Institute of Medical Sciences and Research, Jaipur, Rajasthan, from July 1, 2022, to December 31, 2023. The study included 180 COPD patients aged 40 years and above. Data collection involved clinical profiles, laboratory investigations including cardiac Troponin-T levels, spirometry for pulmonary function tests, and statistical analyses using Karl Pearson’s correlation coefficient and linear regression. Results: Of the 180 patients, 61.67% were male and 38.33% were female, with a mean age of 44.38 ± 10.50 years. A majority (84.44%) resided in rural areas, and 82.78% were Hindu by religion. The study found that 60% of the COPD patients had elevated Troponin-T levels (>0.04 ng/dl). There was a significant negative correlation between Troponin-T levels and spirometry parameters: FEV1 (r= -0.644, p=0.00001) and FEV1/FVC (r= -0.56, p=0.00001). Patients with higher Troponin-T levels exhibited more severe respiratory impairment, indicated by lower FEV1 and FEV1/FVC ratios. Elevated Troponin-T was associated with a greater need for assisted ventilation. Conclusion: Elevated cardiac Troponin-T levels in COPD patients are significantly correlated with the severity of acute exacerbations, serving as a potential marker for early diagnosis and prognosis. The findings suggest that measuring Troponin-T levels can aid in assessing disease severity and guiding clinical management of COPD exacerbations. Further research is needed to explore the mechanisms linking cardiac injury and COPD to enhance patient care.