PURPOSE: Severe COPD exacerbation has established relationship between in-hospital mortality and elevation of troponin-I, but its role in severe asthma exacerbation is not clear. This study was performed to analyze relationship between severity of asthma exacerbation and troponin-I.
METHODS: A retrospective observational analysis was performed in patients with asthma exacerbation admitted to St. Joseph’s Regional Medical Center from January 2003 to March 2010. Out of 2000 asthma exacerbation patients, about 150 patients were tested for cardiac enzymes on or during the admission. Patients with coronary artery disease, EKG showing ST segment elevation/depression, renal failure or sepsis were excluded. Finally, 95 out of 150 patients were included. Troponin-I was primary variable. We compared 49 intubated patients with 46 non-intubated patients using primary variable i.e. troponin-I. Cut off for troponin-I was less than or equal to 0.1 as per institutional laboratory. Highest level of troponin-I was included if multiple sets of cardiac enzyme were done during one admission. Patients admitted more than one time were included separately if they met criterions each admission. Secondary variables recorded were CK total, CK MB, BUN, Creatinine and A-a gradient. The variables were analyzed using Fischer’s exact test.
RESULTS: Troponin-I was elevated in 10 out of 95 (10.52%) patients. Out of 49 intubated patients, 10 (20.4%) had elevated troponin-I compared to 0 out of 46 patients (0%) non-intubated patients (p=0.0012, odds ratio=24.72, 95%CI=1.403-435.7).
CONCLUSION: Elevation of Troponin-I can be seen in asthma exacerbation. There is strong association between severity of asthma exacerbation and troponin-I elevation.
CLINICAL IMPLICATIONS: This study suggests that physicians should be more vigilant to interpret elevation of troponin-I in settings of severe asthma exacerbation.
DISCLOSURE: Tushar Shah, No Financial Disclosure Information; No Product/Research Disclosure Information