C-reactive protein and N-terminal prohormone brain natriuretic peptide as biomarkers in acute exacerbations of COPD leading to hospitalizations.
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.
Centre for Heart Lung Innovation, James Hogg Research Centre, St. Paul's Hospital, Vancouver, British Columbia, Canada.
Yu-Wei Roy
http://orcid.org/0000-0001-8626-7205
YR
Chen
Centre for Heart Lung Innovation, James Hogg Research Centre, St. Paul's Hospital, Vancouver, British Columbia, Canada.|Institute for Heart Lung Health, St. Paul's Hospital, Vancouver, British Columbia, Canada.|PROOF Centre of Excellence, Vancouver, British Columbia, Canada.
Virginia
V
Chen
Centre for Heart Lung Innovation, James Hogg Research Centre, St. Paul's Hospital, Vancouver, British Columbia, Canada.|Institute for Heart Lung Health, St. Paul's Hospital, Vancouver, British Columbia, Canada.|PROOF Centre of Excellence, Vancouver, British Columbia, Canada.
Zsuzsanna
Z
Hollander
Department of Radiology, St. Paul's Hospital, Vancouver, British Columbia, Canada.
Jonathon A
JA
Leipsic
Department of Radiology, St. Paul's Hospital, Vancouver, British Columbia, Canada.
Cameron J
CJ
Hague
Department of Pathology and Laboratory Medicine, University of British Columbia, Vancouver, British Columbia, Canada.
Mari L
ML
DeMarco
Division of Respiratory Medicine, Department of Medicine, University of British Columbia, Vancouver, British Columbia, Canada.|The Lung Centre, Vancouver General Hospital, Vancouver, British Columbia, Canada.
J Mark
JM
FitzGerald
Centre for Heart Lung Innovation, James Hogg Research Centre, St. Paul's Hospital, Vancouver, British Columbia, Canada.|Institute for Heart Lung Health, St. Paul's Hospital, Vancouver, British Columbia, Canada.|PROOF Centre of Excellence, Vancouver, British Columbia, Canada.|Department of Pathology and Laboratory Medicine, University of British Columbia, Vancouver, British Columbia, Canada.
Bruce M
BM
McManus
PROOF Centre of Excellence, Vancouver, British Columbia, Canada.|Department of Computer Sciences, University of British Columbia, Vancouver, British Columbia, Canada.
Raymond T
RT
Ng
Centre for Heart Lung Innovation, James Hogg Research Centre, St. Paul's Hospital, Vancouver, British Columbia, Canada.|Institute for Heart Lung Health, St. Paul's Hospital, Vancouver, British Columbia, Canada.|Division of Respiratory Medicine, Department of Medicine, University of British Columbia, Vancouver, British Columbia, Canada.
Don D
DD
Sin
D000368:Aged; D015415:Biomarkers / Q000097:blood*; D002097:C-Reactive Protein / Q000378:metabolism*; D015331:Cohort Studies; D005260:Female; D006760:Hospitalization; D006801:Humans; D008297:Male; D020097:Natriuretic Peptide, Brain / Q000097:blood*; D010446:Peptide Fragments / Q000097:blood*; D029424:Pulmonary Disease, Chronic Obstructive / Q000097:blood* / Q000378:metabolism*
D015415:Biomarkers; D010446:Peptide Fragments; C109794:pro-brain natriuretic peptide (1-76); D020097:Natriuretic Peptide, Brain; D002097:C-Reactive Protein