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N-terminal pro-brain natriuretic peptide as a prognostic marker in patients with exacerbation of chronic obstructive pulmonary disease

Introduction

Plasma N-terminal pro-brain natriuretic peptide (NT-pro-BNP) levels are elevated in patients with pulmonary disease especially in those with concomitant right ventricular dysfunction. The aim of the present study was to investigate the use of plasma NT-pro-BNP levels as a prognostic tool in patients with exacerbation of chronic obstructive pulmonary disease (COPD).

Methods

A retrospective medical records analysis of all patients hospitalized between June 2009 and June 2012 with the final diagnosis of acute exacerbation of COPD who had undergone NT-pro-BNP measurements at admission followed by echocardiogram.

Results

Seventy-two patients (mean age 69 years, 58% male) with COPD exacerbation but without clinical or echocardiography-oriented evidence of acute cardiac disease were enrolled. The mean forced expiratory volume in 1 second (FEV 1)/forced vital capacity ratio was 44.2% and the mean FEV 1 was 0.82 l. Median NT-pro-BNP levels at admission were 424.4 pg/ml and the tertile limits were 262.1 and 930 pg/ml. NT-pro-BNP levels significantly predicted 30-day mortality (OR: 7.2, 95% CI: 3.9 to 15.2; P < 0.001), (OR: 25, 95% CI: 16.3 to 37.3; P < 0.001) and (OR: 44, 95% CI: 44.5 to 76.2) for each tertile. These associations persisted after adjusting for arterial CO2 pressure, body mass index, age, gender and systolic pulmonary artery pressure.

Conclusion

Among patients with acute exacerbation of chronic pulmonary disease, NT-pro-BNP could be a useful marker for severity and poor prognosis.

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Correspondence to P Stamatis.

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Stamatis, P., Michalopoulou, H. & Stamatis, D. N-terminal pro-brain natriuretic peptide as a prognostic marker in patients with exacerbation of chronic obstructive pulmonary disease. Crit Care 17, P133 (2013). https://doi.org/10.1186/cc12071

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Keywords

  • Chronic Obstructive Pulmonary Disease
  • Vital Capacity
  • Acute Exacerbation
  • Pulmonary Artery Pressure
  • Artery Pressure