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July 25, 2018
The link between the initial NT-proBNP and the incidental exacerbations of COPD in the year of follow-up was examined.
In patients with chronic obstructive pulmonary disease (COPD), N-terminal base
pro-brain natriuretic peptide (NT-proBNP) was an independent predictor of respiratory exacerbations, even without manifest cardiovascular disease (CVD) , according to an analysis of data from the multicenter subpopulation study and intermediate outcome measures in COPD (SPIROMICS; ClinicalTrials.gov Identifier: NCT01969344) published in Respiratory Medicine .
Participants in the SPIROMICS cohort between 40 and 80 years of age with COPD Global Initiative for stages 1 to 4 of chronic obstructive pulmonary disease (GOLD) were evaluated. The link between the initial NT-proBNP and the incidental exacerbations of COPD in the year following follow-up was examined, with adjustments for age, sex, race, current smoking / smoking history, body mass index, forced expiratory volume in one second 1 ) predictive percentage, history of exacerbation, COPD assessment test score, total lung capacity on Thoracic CT and CVD (defined as the occurrence of any coronary heart disease, myocardial infarction or congestive heart failure). 19659006] Out of a total of 1051 participants (mean age, 66.1, 41.4% female), the mean
NT-proBNP was 608.9 pg / mL. The highest mean NT-proBNP was reported in GOLD stage D patients (758.4 pg / mL). Overall, 268 participants had an exacerbation of COPD ≥1. In fact, an increase in the standard deviation of baseline NT-proBNP was significantly associated with an increased risk of exacerbation. COPD 13% (incident risk ratio: 1.13, 95% CI, 1.06-1.19 P <.0001). This association was maintained in participants with and without MCV
The researchers concluded that the effect of detecting and treating early CV dysfunction on exacerbations in patients with COPD warranted further investigation. Exploring the relationship between heart and lung variables in COPD will help us better understand the risk of exacerbations in susceptible individuals.
Disclosures: Several authors report financial relationships with pharmaceutical companies, including Amgen, Boehringer-Ingelheim, GlaxoSmithKline and others
Reference
WW Labaki, Xia M, Murray S, and al. NT-proBNP in stable COPD and future risk of exacerbation: analysis of the SPIROMICS cohort. Respir Med . 2018; 140: 87-93.
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