1. Optimized combination of circulating biomarkers as predictors of prognosis in AECOPD patients complicated with Heart Failure
- Author
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Lingwei Wang, Sinian Li, Binbin Li, Can Yao, Wenwen Liu, Fei Shi, Rongchang Chen, and Mengjie Feng
- Subjects
Male ,medicine.medical_specialty ,Acute exacerbation of chronic obstructive pulmonary disease ,medicine.drug_class ,heart failure ,acute exacerbation of chronic obstructive pulmonary disease ,Logistic regression ,Gastroenterology ,Risk Assessment ,03 medical and health sciences ,Pulmonary Disease, Chronic Obstructive ,0302 clinical medicine ,Predictive Value of Tests ,Internal medicine ,medicine ,Natriuretic peptide ,platelet-lymphocyte ratio ,Humans ,Hospital Mortality ,neutrophil-lymphocyte ratio ,Aged ,Retrospective Studies ,Aged, 80 and over ,Receiver operating characteristic ,business.industry ,Area under the curve ,Retrospective cohort study ,General Medicine ,medicine.disease ,Symptom Flare Up ,Hospitalization ,Circulating biomarkers ,ROC Curve ,C-reaction protein/albumin ratio ,Heart failure ,Feasibility Studies ,030211 gastroenterology & hepatology ,Female ,prognosis ,business ,Biomarkers ,Research Paper - Abstract
BackgroundSystematic inflammation, nutritional status, and cardiovascular function have been associated with the outcomes of acute exacerbation of chronic obstructive pulmonary disease (AECOPD) patients with heart failure (HF). However, the value of their relevant biomarkers in predicting mortality has not been well defined yet. We aimed to investigate the prognostic value of circulating biomarkers including C-reaction protein (CRP) /albumin (ALB), neutrophil–lymphocyte ratio (NLR), platelet–lymphocyte ratio (PLR), and N-terminal pro-brain natriuretic peptide (NT-proBNP) for AECOPD patients with HF.Methods A total of 146 cases of AECOPD complicated with HF were enrolled and classified into survivor group (n=94) and non-survivor group (n=52). The baseline characteristics and blood-based biomarkers were collected. The predictors for prognosis were analyzed by multivariate logistic regression, and the ability to predict 28-day mortality was evaluated by receiver operating characteristics curve (ROC) and the area under the curve (AUC).ResultsThe patients in non-survivors had significantly higher levels of CRP, CRP/ALB, NLR, PCT and NT-proBNP, but lower ALB levels compared to the survivors [145.8±110.1 VS. 66.6±70.2mg/L, 5.9±4.9 VS. 2.3±2.6, 22.2 (11.1, 40.1) VS. 12.0 (6.2, 24.8), 2.6 (0.2, 10.3) VS. 0.08 (0.1, 0.5)ng/ml, 17912.5 (9344.0, 34344.5) VS. 9809.0 (4415.9, 16387.2)ng/ml, 26.8±6.4 VS. 31.0±4.6g/L; P < 0.001, P=0.413). The logistic analysis revealed that CRP/ALB (OR=1.303, 95%CI: 1.145-1.483, PP=0.009) and NLR (OR=1.010, 95%CI: 0.999-1.022, PPConclusionsHigh levels of NLR, CRP/ALB and NT-proBNP may be clinical usefully predictors for death in AECOPD patients with HF. Combination of NLR with CRP/ALB and NT-proBNP can provide a higher accuracy for predicting 28-day mortality in these patients.
- Published
- 2021