Abstract
BackgroundPulmonary hypertension (PH) is one of the common complications in chronic obstructive pulmonary disease (COPD). The study aimed to evaluate the predicting ability of N-terminal pro brain natriuretic peptide (NT-pro BNP) in patients with AECOPD-PH and its relationship with the severity of PH.MethodsA large retrospective case-controlled study (n = 1072) was performed in the First Affiliated Hospital of Xinjiang Medical University from January 2018 to December 2020, and patients were divided into stable COPD (n = 178), AECOPD (n = 688) and AECOPD-PH group (n = 206). Different statistical models were used to screen for reliable and stable biomarkers.ResultsIn unadjusted analysis and PSM (model 1, 2, 3), red cell distribution width (RDW), total bilirubin (TBIL), and NT-pro BNP were higher in patients with AECOPD-PH than those in AECOPD group. Logistic regression analysis showed, when the range of NT-proBNP was 271–1165 pg/mL (OR: 0.293; 95%CI: 0.184–0.467; P < 0.001) and NT-proBNP > 1165 pg/mL (OR: 0.559; 95%CI: 0.338–0.926; P = 0.024), the morbidity risk of PH in AECOPD patients was increased, so did TBIL. In receiver operating characteristic (ROC) curves, at the cut-off value of NT-proBNP was 175.14 pg/mL, AUC was 0.651 (P < 0.001), which was better than TBIL (AUC: 0.590, P < 0.001). As for the results of rank correlation analysis, NT-proBNP had a weak correlation with severity of PH with AECOPD (rs = 0.299, P = 0.001) and its relative relevance with other biomarkers (RDW was 0.359 and TBIL was 0.238, P < 0.001).ConclusionsOur findings suggest that NT-proBNP has a diagnostic efficacy in AECOPD-PH and NT-proBNP has a weak correlation with severity of PH with AECOPD.
Highlights
Pulmonary hypertension (PH) is one of the common complications in chronic obstructive pulmonary disease (COPD)
Patients A single center cross-sectional study was performed at First Affiliated Hospital of Xinjiang Medical University from January 2018 to December 2020, patients were divided into stable COPD, AECOPD and AECOPD patients complicated with PH (AECOPD-PH)
There were 235 (21.92%) patients complicated with diabetes mellitus, 637 (59.14%) patients complicated with coronary atherosclerotic heart disease, it was almost as many patients as complicated with hypertension (n = 634, 59.14%). 20.43% (n = 219) of patients had a history of cerebral infarction
Summary
Pulmonary hypertension (PH) is one of the common complications in chronic obstructive pulmonary disease (COPD). The study aimed to evaluate the predicting ability of N-terminal pro brain natriuretic peptide (NT-pro BNP) in patients with AECOPD-PH and its relationship with the severity of PH. Pulmonary hypertension (PH) may occur in patients with chronic obstructive pulmonary disease (COPD) due to inadequate alveolar ventilation, hypoxia, and pulmonary vascular remodeling [1, 2]. A recently study found that approximately 1% of the world’s population has PH and that the prevalence among people over 65 years old increases to 10% [1]. COPD exacerbations (AECOPD) are episodes of increased respiratory symptoms, dyspnoea, cough and sputum [4]. PH symptoms such as dyspnea on exertion, shortness of breath, and fatigue are non-specific [5]
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