Predictive Value of NT-PRO-BNP for Morbidity and Mortality among Patients of COPD without Underlying Left Ventricular Dysfunction

Abstract

Introduction: Elevated pro BNP level is associated with increased morbidity and mortality in various cardiac and pulmonary conditions, also considered a valuable prognostic tool in acute exacerbation of Chronic Obstructive Pulmonary Disease (AECOPD) without underlying left ventricular dysfunction and also for prognosis of the disease.

Objective: To assess the predictive value of proBNP for morbidity and mortality among patients with AECOPD patients without underlying left ventricular dysfunction and on follow up.

Study Design: Prospective Cohort

Setting: All Medical Wards & Pulmonology Ward– Liaquat University Hospital Hyderabad.

Duration of Study: Six months, May 2022 –December 2022

Subjects and methods: 217 diagnosed patients of COPD (132 male & 85 female) were enrolled by non-probability consecutive technique. All these patients were followed by measuring estimated NT-pro-BNP levels. The patient was followed up at day 0, 3^rd day indoor, and post discharge for 6th month .Patients were excluded from any form of LV dysfunction or other pulmonary diseases.

Results: The mean age was 52.02 ±3.72 years. There were 39.2% females and 60.8% males. COPD stage I was observed in 16 (7.4%), stage II in 81 (37.3%), stage III in 52 (24%), and stage IV in 68 (31.3%) patients. The mean PaO2 was found to be 87.96 ±8.55%. In-hospital morbidity was observed in 77 (35.5%) whereas in-hospital mortality was observed in 54 (24.9%) patients. A significant mean difference of in NT-pro-BNP level was observed in between groups. The mean Pro BNP was significantly higher on 0 day , reduced on 3^rd day but after 6month its value again raised, i.e., 142.27 ±11.63,127.56 ±13.67 and 145.68±16.89 respectively (p-value <0.001).

Conclusion: A significantly higher NT-pro BNP was associated with mortality and morbidity despite of normal LV function in indoor patients of COPD. Persistence elevated Pro BNP has been demonstrated positive predicted values.

Keywords: NT-pro-BNP, acute exacerbation of Chronic Obstructive Pulmonary Disease, left ventricular dysfunction.