{
  "abstract": "Introduction Patients with COPD have an increased risk of major adverse cardiovascular events (MACE) within 30 days of exacerbation. Our study aim was to investigate determinants of troponin rise amongst moderate exacerbations of COPD.Methods Patients with COPD were prospectively recruited from 14 GP practices as part of the STARR2 study. 1 Blood sampling was obtained during steady state, at exacerbation (Day 0) and 14 and 30 days later. Troponin levels were measured using a commercial ELISA (R&D systems, LLD 125pg/mL). Peak dynamic troponin rise was calculated for each participant and defined as the maximum troponin rise between stable state and Day 30 post exacerbation. Significant troponin rise was defined as ≥20 pg/ml (‘Troponin High’ group).Univariate analysis between ‘Troponin High’ and ‘Troponin Low’ groups included patient demographics, spirometry, MRC score, COPD therapies, cardiac risk factors and inflammatory blood biomarkers. Continuous variables were compared using Mann-Whitney U test and categorical variables using Fisher’s exact test.Significant variables on univariant analysis (p ≤ 0.10), were incorporated into a multivariate analysis.Results 65 patients were included in the study, 66% were male, median age was 72 (IQR 66.5–76.5) years, 13 patients (20%) had a history of IHD.21 patients (32.3%) had a significant troponin rise within 30 days of exacerbation. In the multivariate model, significant determinants of troponin rise were raised BMI (p=0.032); higher FEV1% (p=0.015) and higher stable state troponin (p=0.0013). The overall ‘goodness of fit’ R2 for the multivariate model was 0.32 and the analysis of variance 0.042.Conclusion Our study suggests that raised BMI, higher FEV1% and higher stable state troponin can help identify patients at risk of troponin rise during moderate COPD exacerbation. Further work is needed to understand potential mechanisms through which obesity may contribute to cardiac injury at exacerbation. Further studies are required to determine whether higher activity levels amongst patients with less severe COPD leads to increased physiological cardiac stress during moderate exacerbation and explains the increased risk of troponin rise in this patient group.Reference Ramakrishnan S, et al. Blood eosinophil-guided oral prednisolone for COPD exacerbations in primary care (STARR2). Lancet Respir Med. 2024.",
  "authors": [
    {
      "affiliations": [
        "Kings College London, London, UK"
      ],
      "name": "P Dobson"
    },
    {
      "affiliations": [
        "Kings College London, London, UK"
      ],
      "name": "W Ee"
    },
    {
      "affiliations": [
        "Kings College London, London, UK"
      ],
      "name": "J Baker"
    },
    {
      "affiliations": [
        "Kings College London, London, UK"
      ],
      "name": "S Cass"
    },
    {
      "affiliations": [
        "Oxford University, Oxford, UK"
      ],
      "name": "S Ramakrishnan"
    },
    {
      "affiliations": [
        "Kings College London, London, UK"
      ],
      "name": "M Bafadhel"
    },
    {
      "affiliations": [
        "Kings College London, London, UK"
      ],
      "name": "REK Russell"
    }
  ],
  "title": "P155 Determinants of dynamic troponin rise within 30 days of moderate COPD exacerbation",
  "uid": "47ceae2b-6326-5b01-8f2a-0d2c4b71cbf2"
}