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Respiratory medicine · Dec 2012
Diagnostic and prognostic role of biomarkers for pulmonary hypertension in interstitial lung disease.
- Charlotte U Andersen, Søren Mellemkjær, Jens Erik Nielsen-Kudsk, Elisabeth Bendstrup, Ulf Simonsen, and Ole Hilberg.
- Department of Biomedicine, Aarhus University, Wilhelm Meyers Alle 4, Dk-8000 Aarhus, Denmark. cua@farm.au.dk
- Respir Med. 2012 Dec 1; 106 (12): 1749-55.
BackgroundPulmonary 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.MethodsIn a previously described cohort of 212 ILD patients of whom 29 had PH, levels of the above mentioned biomarkers were analyzed as routine tests.ResultsA 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.ConclusionsA 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.Copyright © 2012 Elsevier Ltd. All rights reserved.
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