Journal Article

C-reactive protein and N-terminal prohormone brain natriuretic peptide as biomarkers in acute exacerbations of COPD leading to hospitalizations

Chen, Virginia, Hollander, Zsuzsanna, FitzGerald, J. Mark, Sin, Don D., Leipsic, Jonathon A., McManus, Bruce M., Ng, Raymond T., Chen, Yu-wei Roy, Hague, Cameron J., DeMarco, Mari L.

2017

Overview

There are currently no accepted and validated blood tests available for diagnosing acute exacerbations of chronic obstructive pulmonary disease (AECOPD). In this study, we sought to determine the discriminatory power of blood C-reactive protein (CRP) and N-terminal prohormone brain natriuretic peptide (NT-proBNP) in the diagnosis of AECOPD requiring hospitalizations. The study cohort consisted of 468 patients recruited in the COPD Rapid Transition Program who were hospitalized with a primary diagnosis of AECOPD, and 110 stable COPD patients who served as controls. Logistic regression was used to build a classification model to separate AECOPD from convalescent or stable COPD patients. Performance was assessed using an independent validation set of patients who were not included in the discovery set. Serum CRP and whole blood NT-proBNP concentrations were highest at the time of hospitalization and progressively decreased over time. Of the 3 classification models, the one with both CRP and NT-proBNP had the highest AUC in discriminating AECOPD (cross-validated AUC of 0.80). These data were replicated in a validation cohort with an AUC of 0.88. A combination of CRP and NT-proBNP can reasonably discriminate AECOPD requiring hospitalization versus clinical stability and can be used to rapidly diagnose patients requiring hospitalization for AECOPD.

• Publisher: Public Library of Science,Public Library of Science (PLoS)
• Subject: Aged / Antibiotics / Biology and Life Sciences / Biomarkers / Biomarkers - blood / Blood / Brain / Brain natriuretic peptide / Brain research / C-reactive protein / C-Reactive Protein - metabolism / Care and treatment / Chronic obstructive lung disease / Chronic obstructive pulmonary disease / Classification / Cohort Studies / Diagnosis / Female / Genetic aspects / Heart failure / Hospitalization / Hospitals / Humans / Laboratories / Lung diseases / Male / Medicine / Medicine and Health Sciences / Mortality / Natriuretic Peptide, Brain - blood / Natriuretic peptides / Obstructive lung disease / Patients / Peptide Fragments - blood / Peptides / Physiological aspects / Proteins / Pulmonary Disease, Chronic Obstructive - blood / Pulmonary Disease, Chronic Obstructive - metabolism / Studies