FREQUENCY OF NON-ST-SEGMENT ELEVATION MYOCARDIAL INFARCTION IN PATIENTS PRESENTING WITH ACUTE EXACERBATION OF CHRONIC OBSTRUCTIVE PULMONARY DISEASE

Abstract

Background: Chronic obstructive pulmonary disease (COPD) is the most prevalent preventable lung disease and is defined as persistent airflow limitation due to chronic inflammation of the airways.

Objective: To determine the frequency of non-ST-segment elevation myocardial infarction (NSTEMI) in patients presenting with acute exacerbation of chronic obstructive pulmonary disease.

Methods: This study was a cross-sectional study carried out at Aga Khan University and Hospital, Karachi for six months after approval of synopsis. The subjects were patients with diagnosed COPD who were acutely exacerbating, who were non-probability consecutively sampled within the age range of 40–80 years, both male and female. Patients with a prior myocardial infarction were excluded, as well as those with interstitial lung disease, prior percutaneous coronary intervention or coronary artery bypass grafting (CABG), valvular heart disease, renal failure or anticoagulant use. Demographic and clinical information were collected. All patients had 12 lead ECG and serial serum Troponin I levels. NSTEMI was diagnosed on the basis of the absence of ST-segment elevation on the ECG and Troponin I ≥0.04 ng/mL on two occasions. SPSS 22 software was used for data analysis.

Results: The mean age was 66.95±9.126 years. There were 79 (62.2%) males and 48 (37.8%) females. Troponin I was positive in 45 (35.4%) patients. ECG abnormalities included ST-segment depression in 11 (8.7%) and T-wave inversion in 9 (7.1%). NSTEMI was present in 20 (15.7%) patients. ECG changes (p=0.01) and Troponin I positivity (p=0.001) were significantly associated with NSTEMI.

Conclusion: It was concluded from the study that patients having acute exacerbation of chronic obstructive pulmonary disease (AECOPD) are at a higher risk of developing non-ST-segment elevation myocardial infarction (NSTEMI).