Inflammatory biomarkers in patients with COPD and pulmonary hypertension (PH)

Abstract

Several studies suggested about the role of chronic infflammation in the pathogenesis of PH related to COPD. The aim of study was to evaluate the levels of plasma C-reactive protein (CRP) and fibrinogen and to assess its diagnostic significance in patients with COPD and PH. The study included 63 patients with COPD (GOLD II-IV, age 59.5±10.2 yrs, smoking history 24.1±8.9 pack/years). Patients were divided into groups: 1) without PH (n=21); 2) with moderate PH (n=23); 3) with severe PH (n=19). Moderate PH was defined as a systolic pulmonary artery pressure (SPAP)≥40 mmHg assessed by Doppler echocardiography, severe PH - as SPAP≥55 mmHg. There was an increase in the plasma levels of CRP and fibrinogen in all patients with COPD with statistically significant intra-gpoup differences (p1-2=0.001, p2-3=0.001, p1-3=0.001; p1-2=0.05, p2-3=0.001, p1-3=0.006). Close correlations between SPAP and plasma concentrations of CRP (r=0.74,r=0.05) and fibrinogen (r=0.84,r=0,03) were shown. The area under the ROC curve in COPD and moderate PH for CRP was 0.884 (p 21.5 mg/ml and >4.05 g/l, respectively; for severe PH: >23.5 mg/ml and >5.2 g/l, respectively. In patients with COPD and PH there were positive corelations of plasma CRP and fibrinogen levels with SPAP. Plasma levels of CRP and fibrinigen coud be used to predict PH in COPD patients with good sensitive and specificity.