scholarly journals NT-pro BNP in AECOPD-PH: old biomarker, new insights-based on a large retrospective case-controlled study

2021 ◽  
Vol 22 (1) ◽  
Author(s):  
Fengming Tian ◽  
Wen Song ◽  
Liang Wang ◽  
Qiang Zeng ◽  
Zhenyu Zhao ◽  
...  
Keyword(s):  
Rank Correlation ◽  
Roc Curves ◽  
Controlled Study ◽  
Chronic Obstructive ◽  
Weak Correlation ◽  
Retrospective Case ◽  
Diagnostic Efficacy ◽  
Obstructive Pulmonary Disease ◽  
Distribution Width ◽  
Morbidity Risk

Abstract Background 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. Methods A 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. Results In 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). Conclusions Our 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.

scholarly journals NT-pro BNP in AECOPD-PH: Old Biomarker, New Insights-Based on a Large Retrospective Case-Controlled Study

2021 ◽  
Author(s):  
Fengming Tian ◽  
Wen Song ◽  
Liang Wang ◽  
Qiang Zeng ◽  
Zhenyu Zhao ◽  
...  
Keyword(s):  
Rank Correlation ◽  
Roc Curves ◽  
Controlled Study ◽  
Chronic Obstructive ◽  
Weak Correlation ◽  
Retrospective Case ◽  
Diagnostic Efficacy ◽  
Obstructive Pulmonary Disease ◽  
Distribution Width ◽  
Significant Difference

Abstract 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. A 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). In 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 that RDW had no statistic difference. 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 > 1165pg/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, TBIL had no significant difference, and NT-proBNP had a weak correlation with severity of PH with AECOPD (r=0.299, P=0.001).Our 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.

scholarly journals Red Blood Cell Distribution Width Predicts Pulmonary Hypertension Secondary to Chronic Obstructive Pulmonary Disease

2019 ◽  
Vol 2019 ◽  
pp. 1-6
Author(s):  
Jie Yang ◽  
Chuanmei Liu ◽  
Lingling Li ◽  
Xiongwen Tu ◽  
Zhiwei Lu
Keyword(s):  
Chronic Obstructive Pulmonary Disease ◽  
Pulmonary Hypertension ◽  
Blood Cell ◽  
Tracking System ◽  
Chronic Obstructive ◽  
Cell Distribution ◽  
Obstructive Pulmonary Disease ◽  
Distribution Width ◽  
Copd Patients ◽  
Red Blood Cell Distribution

Purpose. This study aims at investigating the predictive value of red blood cell distribution width (RDW) in pulmonary hypertension (PH) secondary to chronic obstructive pulmonary disease (COPD). Methods. 213 eligible in-hospital COPD patients were reviewed between May 2016 and May 2018, including 39 cases with PH and 174 without PH. Clinical data including demographic characteristics, comorbidities, and results of ultrasound scans, imaging examinations, and laboratory tests were recorded. Results. Increased RDW level was observed in COPD patients with PH compared with COPD patients without PH, with 15.10 ± 1.72% versus 13.70 ± 1.03%, respectively (p<0.001). RDW shared positive relationships with brain natriuretic peptide (BNP) (p=0.001, r = 0.513), pulmonary artery (PA) systolic pressure (p=0.014, r = 0.390), and PA-to-ascending aorta (A) ratio (PA : A) (p=0.001, r = 0.502). Multivariate analysis indicated that RDW, BNP, and PA : A > 1 were the independent risk factors of PH secondary to COPD (p<0.05). The AUC of the RDW in patients with PH was 0.749 ± 0.054 (p<0.001). The optimal cutoff value of RDW for predicting PH was 14.65, with a sensitivity and a specificity value of 69.2% and 82.8%, respectively. Conclusion. RDW is significantly increased in COPD patients with PH and thus may be a useful biomarker for PH secondary to COPD.

scholarly journals Lifestyle and comorbid conditions as risk factors for community-acquired pneumonia in outpatient adults (NEUMO-ES-RISK project)

2019 ◽  
Vol 6 (1) ◽  
pp. e000359 ◽  
Author(s):  
Irene Rivero-Calle ◽  
Miriam Cebey-López ◽  
Jacobo Pardo-Seco ◽  
José Yuste ◽  
Esther Redondo ◽  
...  
Keyword(s):  
Risk Factors ◽  
Primary Care ◽  
Dental Hygiene ◽  
Community Acquired Pneumonia ◽  
Incidence Density ◽  
Controlled Study ◽  
Chronic Obstructive ◽  
Comorbid Conditions ◽  
Obstructive Pulmonary Disease ◽  
Sampling Ratio

IntroductionInformation about community-acquired pneumonia (CAP) risk in primary care is limited. We assess different lifestyle and comorbid conditions as risk factors (RF) for CAP in adults in primary care.MethodsA retrospective-observational-controlled study was designed. Adult CAP cases diagnosed at primary care in Spain between 2009 and 2013 were retrieved using the National Surveillance System of Primary Care Data (BiFAP). Age-matched and sex-matched controls were selected by incidence density sampling (ratio 2:1). Associations are presented as percentages and OR. Binomial regression models were constructed to avoid bias effects.Results51 139 patients and 102 372 controls were compared. Mean age (SD) was 61.4 (19.9) years. RF more significantly linked to CAP were: HIV (OR [95% CI]: 5.21 [4.35 to 6.27]), chronic obstructive pulmonary disease (COPD) (2.97 [2.84 to 3.12]), asthma (2.16 [2.07,2.26]), smoking (1.96 [1.91 to 2.02]) and poor dental hygiene (1.45 [1.41 to 1.49]). Average prevalence of any RF was 82.2% in cases and 69.2% in controls (2.05 [2.00 to 2.10]). CAP rate increased with the accumulation of RF and age: risk associated with 1RF was 1.42 (1.37 to 1.47) in 18–60-year-old individuals vs 1.57 (1.49 to 1.66) in >60 years of age, with 2RF 1.88 (1.80 to 1.97) vs 2.35 (2.23, 2.48) and with ≥ 3 RF 3.11 (2.95, 3.30) vs 4.34 (4.13 to 4.57).DiscussionPrevalence of RF in adult CAP in primary care is high. Main RFs associated are HIV, COPD, asthma, smoking and poor dental hygiene. Our risk stacking results could help clinicians identify patients at higher risk of pneumonia.

scholarly journals Impact of community-based chronic obstructive pulmonary disease service, a multidisciplinary intervention in an area of high deprivation: a longitudinal matched controlled study

BMJ Open ◽  
2020 ◽  
Vol 10 (5) ◽  
pp. e032931
Author(s):  
Pooja Saini ◽  
Tanith Rose ◽  
Jennifer Downing ◽  
Bashir Matata ◽  
Samantha Pilsworth ◽  
...  
Keyword(s):  
Chronic Obstructive Pulmonary Disease ◽  
Pulmonary Disease ◽  
Hospital Admissions ◽  
Controlled Study ◽  
Control Group ◽  
Chronic Obstructive ◽  
Community Based ◽  
Obstructive Pulmonary Disease ◽  
Emergency Hospital ◽  
Emergency Hospital Admissions

ObjectiveTo examine the effects of a consultant-led, community-based chronic obstructive pulmonary disease (COPD) service, based in a highly deprived area on emergency hospital admissions.DesignA longitudinal matched controlled study using difference-in-differences analysis to compare the change in outcomes in the intervention population to a matched comparison population, 5 years before and after implementation.SettingA deprived district in the North West of England between 2005 and 2016.InterventionA community-based, consultant-led COPD service providing diagnostics, treatment and rehabilitation from 2011 to 2016.Main outcome measuresEmergency hospital admissions, length of stay per emergency admission and emergency readmissions for COPD.ResultsThe intervention was associated with 24 fewer emergency COPD admissions per 100 000 population per year (95% CI −10.6 to 58.8, p=0.17) in the postintervention period, relative to the control group. There were significantly fewer emergency admissions in populations with medium levels of deprivation (64 per 100 000 per year; 95% CI 1.8 to 126.9) and among men (60 per 100 000 per year; 95% CI 12.3 to 107.3).ConclusionWe found limited evidence that the service reduced emergency hospital admissions, after an initial decline the effect was not sustained. The service, however, may have been more effective in some subgroups.

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