Chronic Obstructive Pulmonary Disease and Pulmonary Hypertension: A Comparative Study of Biomarkers and Clinical Indicators

Yingjun Huang, Binbin Qin, Bin Shen, Jiayan Zhu, Qi Zheng, Xingdong Zheng, Jingwei Hu, Yajun Song

https://doi.org/10.1002/pul2.70228 

Abstract

A major consequence of acute exacerbation of chronic obstructive pulmonary disease (AECOPD) is pulmonary hypertension (PH), which raises morbidity and mortality rates. This study assessed biomarker profiles, clinical characteristics and diagnostic efficacy of important coagulation and inflammatory markers in AECOPD patients who have varying degrees of PH severity. A total of 248 AECOPD patients were included and divided into three groups according to the severity of their PH. Analysis of biomarker levels, such as B-type natriuretic peptide (BNP), troponin I (TNT-I), d-dimer, C-reactive protein (CRP), and coagulation markers, besides pulmonary artery systolic pressure was done. These biomarkers' diagnostic precision for PH was evaluated by receiver operating characteristic curve analysis. PH patients were much older than those without PH. The moderate to severe PH group had highest BNP levels (619.92 ± 945.81 pg/mL), which rose gradually with PH severity. TNT-I, CRP and D-dimer showed similar patterns. The most dependable biomarker for PH, according to ROC analysis, was BNP (AUC = 0.803), followed by TNT-I (AUC = 0.712) and D-dimer (AUC = 0.694). Prothrombin and Activated Partial Thromboplastin had a considerable predictive value, although fibrinogen's diagnostic utility was restricted (AUC = 0.559). BNP showed the highest predictive value with an AUC, suggested BNP is most important biomarker for PH in AECOPD patients, TNT-I and D-dimer serve as useful secondary markers. The observed elevations in coagulation and inflammatory markers indicate their potential role in PH pathogenesis.

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