Author + information
- Nicholas L. Mills,
- Julie A. Anderson,
- Robert D. Brook,
- Peter M.A. Calverley,
- Bartolome R. Celli,
- Nicholas J. Cowans,
- Courtney Crim,
- Ian J. Dixon,
- Sally Kilbride,
- Fernando Martinez,
- Jørgen Vestbo,
- Julie Yates and
- David E. Newby
Background: Patients with chronic obstructive pulmonary disease (COPD) are at increased risk of cardiovascular (CV) events. We evaluated the association between plasma high-sensitivity cardiac troponin I (cTnI) concentration and CV events in patients with COPD and heightened CV risk.
Methods: In a double-blind randomised controlled trial, 16,485 patients with COPD and CV disease or risk factors were randomised to once daily inhaled placebo, fluticasone furoate (100 µg; FF), vilanterol (25 µg; VI), or combined FF/VI. Plasma cTnI concentrations were measured with a high-sensitivity assay (Abbott Diagnostics) in a subgroup of 1,599 patients. Outcomes were CV events or COPD exacerbations with follow-up of approximately 1.6 years.
Results: Baseline plasma cTnI concentrations were above the lower limit of detection (1.0 ng/L) in 1,559 (97.5%) patients and were unaffected by inhaled therapies at 3 months (p>0.05 for all). Compared to the lowest tertile (<3.0 ng/L), patients in the highest cTnI tertile (≥5.5 ng/L) were at greater risk of CV events (Figure 1A) even after adjustment for CV risk factors (hazard ratio 3.0, 95% confidence interval 1.5 to 6.2, P=0.002). There were no differences in COPD exacerbations between baseline cTnI tertiles (Figure 1B) even after adjustment (post hoc P>0.05).
Conclusions: In patients with COPD and heightened CV risk, plasma cTnI concentrations are a specific and independent predictor of future CV events that are not associated with inhaled therapies or COPD exacerbations.
Poster Hall, Hall C
Saturday, March 18, 2017, 3:45 p.m.-4:30 p.m.
Session Title: Innovations in Cardiovascular Risk Assessment and Reduction
Abstract Category: 32. Prevention: Clinical
Presentation Number: 1235-052
- 2017 American College of Cardiology Foundation