A Study of Cardiac Troponin T Levels in Acute Exacerbation of Copd and its Correlation with Severity.

Chronic obstructive pulmonary disease (COPD) is a significant health burden and is one of the leading causes of death having rising mortality rate in developed and developing countries. Cardiac troponin t (cTnT) is an established myocardial injury marker and not only increases in flow- limiting coronary artery stenosis or occlusion of coronary arteries but also in pulmonary embolism, septic shock, heart failure and stroke. The positive association between elevation of cTnT and neutrophils due to exaggerated inflammatory response leading to myocardial injury and increased cTnT can have prognostic value in acute exacerbation of COPD. Material: The present study was conducted with the aim of predicting the severity of COPD exacerbation based on level of cardiac TnT. 85 patients with a diagnosis of COPD age more than 20 years admitted in general medicine wards in SMS medical college during 2020 were enrolled in this study. Spirometry and Chest Xray were used in diagnosing COPD. Troponin T level was measured within 1 hour of admission. Severity of the exacerbation was estimated by PaO2 & PaCO2 levels and need for assisted ventilation. Observation: Here, in our study 43.53% cases has troponin-T elevated. And amongst those with Trop T elevated 82.4% needed assisted ventilation compared to 24.6 % patients with normal Trop T needing assisted ventilation indicating significant positive correlation of Trop t level with need for assisted ventilation in acute exacerbation of COPD. Amongst those with elevated Trop T, mean oxygen saturation was77.97 % and mean pco2 was 73%. Whilst those with normal troponin T level they had mean oxygen saturation of 86% and mean co2 level of 42% indicating that those with elevated cardiac Trop T has more severe hypoxia and more severe hypercapnia compared to those with normal cardiac Trop T level implying significant positive association of elevated Trop T level with severity of COPD exacerbation Conclusion: This observation implies there is a positive correlation of elevated trop T level and severity of acute exacerbation of COPD in terms of need for assisted ventilation, severity of hypoxia and hypercapnia .So assessment of Trop T level in acute exacerbation of COPD will be having prognostic benefit and can be used for assessing course of the disease along with better management of the patients.