Cited 8 times since 2010 (0.6 per year) source: EuropePMC COPD, Volume 7, Issue 1, 1 1 2010, Pages 70-75 Predictive value of NT-proBNP in vascular surgery patients with COPD and normal left ventricular systolic function. van Gestel YR, Goei D, Hoeks SE, Sin DD, Flu WJ, Stam H, Mertens FW, Bax JJ, van Domburg RT, Poldermans D
N-terminal pro-B-type natriuretic peptide (NT-proBNP) is commonly used to identify a cardiac cause of dyspnoea. However, patients with chronic obstructive pulmonary disease (COPD) may also have increased plasma NT-proBNP levels because of right-sided myocardial stress caused by pulmonary hypertension. We investigated the relationship between COPD and elevated NT-proBNP levels as well as the impact of elevated NT-proBNP levels on mortality in vascular surgery patients with normal left ventricular systolic function. Prior to vascular surgery, NT-proBNP levels, pulmonary function and left ventricular ejection fraction (LVEF) were assessed in 376 patients. Only patients with a LVEF > 40% were included; n = 261. Elevated NT-proBNP levels were defined as > or =500 pg/ml. Firstly, we assessed the relationship between COPD and NT-proBNP levels. Secondly, we investigated the association between elevated NT-proBNP levels and one-year mortality. COPD was independently associated with elevated NT-proBNP levels (OR 3.36, 95%CI 1.30-8.65) with significant associations found for mild and severe COPD. Elevated NT-proBNP levels were associated with increased one-year mortality in patients with (HR 7.73, 95%CI 1.60-37.43) and without COPD (HR 3.44, 95%CI 1.10-10.73). COPD was associated with elevated NT-proBNP levels in patients with a normal LVEF undergoing vascular surgery. Elevated NT-proBNP levels independent of other well-established risk factors were associated with increased one-year mortality. NT-proBNP may be useful biomarker to risk stratify patients with COPD.
