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Midregional pro-atrial natriuretic peptide predicts survival in exacerbations of COPD

Bernasconi, M. and Tamm, M. and Bingisser, R. and Miedinger, D. and Leuppi, J. and Muller, B. and Christ-Crain, M. and Stolz, D.. (2010) Midregional pro-atrial natriuretic peptide predicts survival in exacerbations of COPD. Chest, 140 (1). pp. 91-99.

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Official URL: http://edoc.unibas.ch/56724/

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Abstract

Abstract BACKGROUND: Recently, systemic biomarkers have gained interest to monitor and assess the clinical evolution of respiratory disease. We investigated whether MR-proANP on admission to hospital for exacerbation predicts survival in patients with COPD. METHODS: 167 patients (70 years old, 75 male) admitted to the hospital for exacerbation were followed-up for 2 years. MR-proANP was measured on admission, after 14 days and 6 months. The predictive value of clinical, functional and laboratory parameters on admission were assessed by Cox-regression analyses. The time to death was analyzed by Kaplan-Meier survival curves. RESULTS: MR-proANP was significantly higher on admission for exacerbation compared to recovery and stable state (p=0.004 for the comparison among all time points). MR-proANP correlated with Charlson's condition and age related score (p>0.0001), left ventricular ejection fraction (p>0.0001), C-reactive protein (p=0.037), and FEV(1)% predicted (p=0.004). MR-proANP levels were similar in patients requiring ICU treatment and in those treated in the medical ward (p=0.086). 37 (22%) patients deceased within 2 years. MR-proANP levels were higher in non-survivors as compared to survivors (median [IQR] 185 pmol/l [110-286] vs 92 pmol/l [56-158], p>0.001). Mortality was higher across MR-proANP quartiles (log rank p>0.0001). Charlson's condition and age related score (p=0.001), PaCO2 (p>0.0001), and MR-proANP (p=0.001) predicted mortality in the univariate Cox-regression model. Both MR-proANP and PaCO2 were independent predictors of mortality in the multivariate Cox-regression model. CONCLUSIONS: MR-proANP at exacerbation is associated with 2-years long-term survival in patients with exacerbation of COPD.
Faculties and Departments:03 Faculty of Medicine > Bereich Medizinische Fächer (Klinik) > Allgemeine innere Medizin AG > Argovia Professur für Medizin (Müller)
03 Faculty of Medicine > Departement Klinische Forschung > Bereich Medizinische Fächer (Klinik) > Allgemeine innere Medizin AG > Argovia Professur für Medizin (Müller)
UniBasel Contributors:Müller, Beat
Item Type:Article, refereed
Article Subtype:Research Article
Publisher:Elsevier
ISSN:0012-3692
e-ISSN:1931-3543
Note:Publication type according to Uni Basel Research Database: Journal article
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Last Modified:29 Nov 2017 10:40
Deposited On:29 Nov 2017 10:40

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