Journal article
NT-proBNP in stable COPD and future exacerbation risk: Analysis of the SPIROMICS cohort
Respiratory medicine, Vol.140, pp.87-93
07/2018
DOI: 10.1016/j.rmed.2018.06.005
PMCID: PMC6084793
PMID: 29957287
Abstract
High N-terminal pro-brain natriuretic peptide (NT-proBNP) during COPD exacerbations is associated with worse clinical outcomes. The prognostic value of NT-proBNP measured during clinical stability has not been well characterized.
We studied SPIROMICS participants 40–80 years of age with COPD GOLD spirometric stages 1–4. The association between baseline NT-proBNP and incident COPD exacerbations within one year of follow-up was tested using zero-inflated Poisson regression models adjusted for age, gender, race, body mass index, current smoking status, smoking history, FEV1 percent predicted, COPD Assessment Test score, exacerbation history, total lung capacity on chest CT and cardiovascular disease (any of coronary artery disease, myocardial infarction or congestive heart failure).
Among 1051 participants (mean age 66.1 years, 41.4% women), mean NT-proBNP was 608.9 pg/ml. Subjects in GOLD stage D had the highest mean NT-proBNP. After one year of follow-up, 268 participants experienced one or more COPD exacerbations. One standard deviation increase in baseline NT-proBNP was associated with a 13% increase in the risk of incident exacerbations (incident risk ratio 1.13; 95% CI 1.06–1.19; p < 0.0001). This association was maintained in participants with and without cardiovascular disease.
Baseline NT-proBNP in COPD is an independent predictor of respiratory exacerbations, even in individuals without overt cardiac disease. The impact of detection and treatment of early cardiovascular dysfunction on COPD exacerbation frequency warrants further investigation.
•NT-proBNP level in stable COPD is highest in GOLD stage D.•NT-proBNP in stable COPD is an independent predictor of respiratory exacerbations.•This association is maintained even in the absence of cardiovascular disease.
Details
- Title: Subtitle
- NT-proBNP in stable COPD and future exacerbation risk: Analysis of the SPIROMICS cohort
- Creators
- Wassim W. Labaki - University of Michigan–Ann ArborMeng Xia - University of Michigan–Ann ArborSusan Murray - University of Michigan–Ann ArborJeffrey L. Curtis - University of Michigan–Ann ArborR. Graham Barr - Columbia UniversitySurya P. Bhatt - University of Alabama at BirminghamEugene R. Bleecker - University of ArizonaNadia N. Hansel - Johns Hopkins UniversityChristopher B. Cooper - University of California, Los AngelesMark T. Dransfield - University of Alabama at BirminghamJ. Michael Wells - University of Alabama at BirminghamEric A. Hoffman - University of IowaRichard E. Kanner - University of UtahRobert Paine - University of UtahVictor E. Ortega - Atrium Health Wake Forest BaptistStephen P. Peters - Atrium Health Wake Forest BaptistJerry A. Krishnan - University of Illinois at ChicagoRussell P. Bowler - University of DenverDavid J. Couper - University of North Carolina at Chapel HillPrescott G. Woodruff - University of California, San FranciscoFernando J. Martinez - Cornell UniversityCarlos H. Martinez - University of Michigan–Ann ArborMeiLan K. Han - University of Michigan–Ann Arbor
- Resource Type
- Journal article
- Publication Details
- Respiratory medicine, Vol.140, pp.87-93
- Publisher
- Elsevier Ltd
- DOI
- 10.1016/j.rmed.2018.06.005
- PMID
- 29957287
- PMCID
- PMC6084793
- ISSN
- 0954-6111
- eISSN
- 1532-3064
- Grant note
- DOI: 10.13039/100000002, name: National Institutes of Health/National Heart, Lung, and Blood Institute, award: HHSN268200900013C, HHSN268200900014C, HHSN268200900015C, HHSN268200900016C, HHSN268200900017C, HHSN268200900018C, HHSN268200900019C, HHSN268200900020C; DOI: 10.13039/100000002, name: NIH; name: COPD; DOI: 10.13039/100000002, name: National Institutes of Health, award: R01HL122438, R01HL126838, T32HL007749, K24HL138188; DOI: 10.13039/100000002, name: NIH; DOI: 10.13039/100000050, name: NHLBI; DOI: 10.13039/501100004628, name: MedImmune; DOI: 10.13039/100000738, name: Department of Veterans Affairs; DOI: 10.13039/100001448, name: Alpha-1 Foundation; DOI: 10.13039/100000002, name: NIH, award: K23HL133438; DOI: 10.13039/100000050, name: NHLBI; DOI: 10.13039/100000042, name: Amgen; name: AstraZeneca-MedImmune; name: Boehringer-Ingelheim; name: Genentech/Roche; DOI: 10.13039/100004330, name: GlaxoSmithKline; name: Janssen/Johnson & Johnson; DOI: 10.13039/100008272, name: Novartis; DOI: 10.13039/100004319, name: Pfizer; name: Sanofi-Regneron; DOI: 10.13039/100006259, name: Teva; name: Equinox Health Clubs; DOI: 10.13039/100002429, name: Amgen; name: Spiration; DOI: 10.13039/100000002, name: NIH; DOI: 10.13039/100000005, name: Department of Defense; DOI: 10.13039/100000002, name: NIH/NHLBI, award: K08HL123940; DOI: 10.13039/100004330, name: GlaxoSmithKline; name: AstraZeneca; DOI: 10.13039/100005564, name: Gilead; name: Quintiles; name: Mylan; DOI: 10.13039/100000897, name: Cystic Fibrosis Foundation; DOI: 10.13039/100000002, name: NIH; DOI: 10.13039/100000002, name: National Institutes of Health; DOI: 10.13039/100000050, name: National Heart, Lung, and Blood Institute; DOI: 10.13039/100000002, name: NIH, award: HL118128; DOI: 10.13039/100000002, name: NIH
- Language
- English
- Date published
- 07/2018
- Academic Unit
- Roy J. Carver Department of Biomedical Engineering; Radiology; Internal Medicine
- Record Identifier
- 9984318706802771
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