Usefulness of mid regional pro-atrial natriuretic peptide in the exacerbations of chronic obstructive pulmonary disease.
BACKGROUND
A recent approach for the management of chronic obstructive pulmonary disease (COPD) is the measurement of systemic biomarkers. The aim of this study was to evaluate the usefulness of mid regional pro-atrial natriuretic peptide (MR-proANP) to predict short and long term prognosis.


METHODS
We included 318 COPD patients: 46 in a stable phase, 217 undergoing an exacerbation and 55 with pneumonia. Serum samples were collected at admission. For 20 exacerbated patients, we also collected a second sample one month later. MR-proANP was measured by an inmunofluorescent assay.


RESULTS
Statistically higher levels of MR-proANP were found in patients with pneumonia when comparing to patients in the stable state (p=0.031). For those patients with paired samples, MR-proANP decreased statistically one month later (p=0.027). MR-proANP showed significant lower levels in exacerbations with isolation of pathogenic bacteria (p=0.011). MR-proANP levels were higher in patients that died within one month, decreasing as long as the moment of death occurred later on (p=0.163).


CONCLUSIONS
The identification of exacerbation etiology by means of MR-proANP is not clinically reliable. Levels of MR-proANP vary depending on the clinical status, being higher during pneumonia in comparison to the stable state. MR-proANP levels were higher in patients that died within one month after the exacerbation episode.
Hospital Universitari Germans Trias i Pujol, Universitat Autònoma de Barcelona, Badalona, Instituto de Salud Carlos III, Spain.
Alicia
A
Lacoma
Cristina
C
Prat
Felipe
F
Andreo
Luis
L
Lores
Irene
I
Latorre
Miguel
M
Pérez
Juan
J
Ruiz-Manzano
Vicente
V
Ausina
Jose
J
Dominguez
D000368:Aged; D009320:Atrial Natriuretic Factor / Q000032:analysis* / Q000276:immunology; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D011014:Pneumonia / Q000175:diagnosis / Q000209:etiology; D011379:Prognosis; D029424:Pulmonary Disease, Chronic Obstructive / Q000175:diagnosis* / Q000209:etiology / Q000276:immunology
D009320:Atrial Natriuretic Factor