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

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.