Adding mild diuretics to standard treatment for acute exacerbation of COPD reduced plasma BNP levels to 77.43 pg/ml at 8 days compared to 118.84 pg/ml with standard treatment alone.
RCT (n=41)
Randomized
Does adding mild diuretics to standard treatment reduce plasma BNP levels in patients with acute exacerbation of COPD without clinical corpulmonale?
Adding mild diuretics to standard therapy for acute COPD exacerbations significantly reduces elevated plasma BNP levels in patients without clinical corpulmonale.
Absolute Event Rate: 77.43% vs 118.84%
Background: Brain natriuretic peptide (BNP) is a cardiac biomarker originates from the stretched myocardium. Aim of the work: To evaluate the effect of mild diuretic treatment on the plasma BNP level in patients with an acute exacerbation of COPD without clinical findings of corpulmonale. Material and methods: 31 patients with acute exacerbation of COPD without any clinical evidence of corpulmonale who had elevated plasma BNP concentrations (group I) and 10 patients with stable COPD as controls (group II) participated in this study. A mild diuretic treatment in addition to the standard treatment for an acute attack of COPD was randomized to 16 patients in group 1 (group IA) and the remaining patients in group I only took standard treatment for acute COPD exacerbation (group IB). Plasma BNP concentrations were measured on admission and repeated on the 8th day post therapy. Results: Plasma BNP levels (mean ± SD in pg/ml) were significantly elevated in acute exacerbation of COPD than in stable patients (187.01 ± 62.7 vs 96.17 ± 26.97, p = 0.0001). There was a significant decrease in plasma BNP level in AECOPD patients post therapy, which was more striking in group IA than IB (179.09 ± 52.55 pre-treatment vs 77.43 ± 15.46 post-treatment with p = 0.0001 and 195.48 ± 72.93 pre-treatment vs 118.84 ± 45.19 post-treatment with p = 0.0001) respectively. There was a significant correlation between plasma BNP level and right ventricle end diastolic diameter (r = 0.5, p = 0.001) and pulmonary artery systolic pressure (r = 0.3, p = 0.04). Conclusion: Adding mild diuretics to the standard treatment for an acute attack of COPD may rapidly reduce plasma BNP levels in COPD patients with acute exacerbations who have high plasma BNP levels without any clinical evidence of corpulmonale.
Mohammad et al. (Sun,) conducted a rct in Acute exacerbation of COPD (n=41). Mild diuretic treatment vs. Standard treatment alone was evaluated on Plasma BNP level on the 8th day post therapy. Adding mild diuretics to standard treatment for acute exacerbation of COPD reduced plasma BNP levels to 77.43 pg/ml at 8 days compared to 118.84 pg/ml with standard treatment alone.