NT-proBNP levels were significantly elevated in stable COPD (SMD 0.51; 95% CI 0.13-0.89; p=0.0092) and further increased during acute exacerbations and in non-survivors.
Meta-Analysis (n=8,534)
Do NT-proBNP levels vary across different stages, severities, and comorbidities in patients with COPD?
NT-proBNP levels are significantly elevated in severe COPD, acute exacerbations, and in the presence of comorbidities like pulmonary hypertension and heart failure, suggesting its utility as a prognostic biomarker.
Standardized Mean Difference: 0.51 (95% CI 0.13–0.89)
p-value: p=0.0092
Purpose: NT-proBNP, a peptide biomarker synthesized and secreted by cardiomyocytes in response to cardiac load, has gained attention in recent years for its potential role in respiratory diseases. Chronic Obstructive Pulmonary Disease (COPD), a chronic and progressive inflammatory condition affecting the respiratory system, is frequently associated with comorbidities involving the cardiovascular system. Consequently, the aim of this systematic review and meta-analysis was to evaluate the variations in NT-proBNP levels across distinct patient groups with COPD and establish a foundation for future investigations into the precise clinical significance of NT-proBNP in COPD. Methods: The search databases for this study were conducted in PubMed, Excerpt Medica database (Embase), Web of Science (WOS), and Cochrane Library databases. Databases were searched for studies on the predictive value of NT-proBNP in adult COPD patients. Results: A total of 29 studies (8534 participants) were included. Patients with stable COPD exhibit elevated levels of NT-proBNP standardized mean difference(SMD) [95CI%=0.51 0.13,0.89; p =0.0092]. COPD patients with predicted forced expiratory volume in 1 s (FEV 1 ) < 50% exhibit significantly elevated levels of NT-proBNP compared to those with FEV 1 ⩾50%SMD [95CI%=0.17 0.05,0.29; p =0.0058]. NT-proBNP levels were significantly higher in acute exacerbations (AECOPD) compared to patients with stable COPD SMD [95CI%=1.18 0.07,2.29; p =0.037]. NT-proBNP levels was significantly higher in non-survivors than in survivors of hospitalised AECOPD patients SMD [95CI%=1.67 0.47,2.88; p =0.0063]. Both COPD patients with pulmonary hypertension(PH) SMD [95CI%=0.82 0.69,0.96; p < 0.0001] and chronic heart failure(CHF) SMD [95CI%=1.49 0.96,2.01; p < 0.0001] showed higher NT-proBNP level. Conclusion: NT-proBNP, a biomarker commonly used in clinical practice to evaluate cardiovascular disease, demonstrates significant variations in different stages of COPD and during the progression of the disease. The fluctuations in NT-proBNP levels could be indicative of the severity of pulmonary hypoxia and inflammation and cardiovascular stress among COPD patients. Therefore, assessing NT-proBNP levels in COPD patients can aid in making informed clinical decisions. Keywords: amino-terminal pro-brain natriuretic peptide, chronic obstructive pulmonary disease, acute exacerbation of chronic obstructive pulmonary disease, chronic heart failure, meta-analysis
Su et al. (Mon,) conducted a meta-analysis in Chronic Obstructive Pulmonary Disease (COPD) (n=8,534). COPD severity and exacerbation status vs. Less severe COPD, stable disease, or survivors was evaluated on NT-proBNP levels in stable COPD (SMD 0.51, 95% CI 0.13-0.89, p=0.0092). NT-proBNP levels were significantly elevated in stable COPD (SMD 0.51; 95% CI 0.13-0.89; p=0.0092) and further increased during acute exacerbations and in non-survivors.