title: Diagnostic and prognostic role of biomarkers for pulmonary hypertension in interstitial lung disease.
abstract: BACKGROUND
  Pulmonary hypertension (PH) is an important complication to interstitial lung disease (ILD). The aim of the present study was to investigate the relation of NT-proBNP, fibrin D-dimer, troponin-T, uric acid and exhaled nitric oxide (NO) to the presence of PH and mortality in ILD.
  
  
  METHODS
  In a previously described cohort of 212 ILD patients of whom 29 had PH, levels of the above mentioned biomarkers were analyzed as routine tests.
  
  
  RESULTS
  A value of NT-proBNP below 95 ng/l had a negative predictive value for PH of 99% (95% CI: 94-100). Values of troponin-T were higher in patients with PH (median (inter quartile range) = 9 (9-20) vs. 9(9-10) ng/l), and the odds ratio (OR) for PH was increased in patients with abnormal levels of uric acid (OR (95% CI) = 3.1(1.1-8.8)). NT-proBNP and troponin-T values above the 50(th) percentile, and uric acid and fibrin D-dimer values above the 90th percentile were each associated with increased mortality.
  
  
  CONCLUSIONS
  A value of NT-proBNP below 95 ng/l may be used as a rule-out test for PH in ILD, while an abnormal value of uric acid is a risk factor for PH. NT-proBNP, troponin-T, uric acid and fibrin D-dimer have prognostic value in ILD patients, while exhaled levels of NO do not seem to predict PH or mortality.
authors.affiliation: Department of Biomedicine, Aarhus University, Wilhelm Meyers Alle 4, Dk-8000 Aarhus, Denmark. cua@farm.au.dk
authors.forename: Charlotte U
authors.initials: CU
authors.lastname: Andersen
authors.forename: Søren
authors.initials: S
authors.lastname: Mellemkjær
authors.forename: Jens Erik
authors.initials: JE
authors.lastname: Nielsen-Kudsk
authors.forename: Elisabeth
authors.initials: E
authors.lastname: Bendstrup
authors.forename: Ulf
authors.initials: U
authors.lastname: Simonsen
authors.forename: Ole
authors.initials: O
authors.lastname: Hilberg
mesh_terms: D015415:Biomarkers / Q000378:metabolism*; D003430:Cross-Sectional Studies; D005338:Fibrin Fibrinogen Degradation Products / Q000378:metabolism; D006801:Humans; D006976:Hypertension, Pulmonary / Q000175:diagnosis* / Q000401:mortality; D017563:Lung Diseases, Interstitial / Q000150:complications* / Q000401:mortality; D020097:Natriuretic Peptide, Brain / Q000378:metabolism; D009569:Nitric Oxide / Q000378:metabolism; D010446:Peptide Fragments / Q000378:metabolism; D011379:Prognosis; D011658:Pulmonary Fibrosis / Q000150:complications / Q000401:mortality; D012372:ROC Curve; D020107:Troponin T / Q000378:metabolism; D014527:Uric Acid / Q000378:metabolism
chemical_list: D015415:Biomarkers; D005338:Fibrin Fibrinogen Degradation Products; D010446:Peptide Fragments; D020107:Troponin T; C036309:fibrin fragment D; C109794:pro-brain natriuretic peptide (1-76); D020097:Natriuretic Peptide, Brain; D014527:Uric Acid; D009569:Nitric Oxide