Diagnostic and prognostic role of biomarkers for pulmonary hypertension in interstitial lung disease

Respir Med. 2012 Dec;106(12):1749-55. doi: 10.1016/j.rmed.2012.09.003. Epub 2012 Sep 30.

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.

MeSH terms

  • Biomarkers / metabolism*
  • Cross-Sectional Studies
  • Fibrin Fibrinogen Degradation Products / metabolism
  • Humans
  • Hypertension, Pulmonary / diagnosis*
  • Hypertension, Pulmonary / mortality
  • Lung Diseases, Interstitial / complications*
  • Lung Diseases, Interstitial / mortality
  • Natriuretic Peptide, Brain / metabolism
  • Nitric Oxide / metabolism
  • Peptide Fragments / metabolism
  • Prognosis
  • Pulmonary Fibrosis / complications
  • Pulmonary Fibrosis / mortality
  • ROC Curve
  • Troponin T / metabolism
  • Uric Acid / metabolism

Substances

  • Biomarkers
  • Fibrin Fibrinogen Degradation Products
  • Peptide Fragments
  • Troponin T
  • fibrin fragment D
  • pro-brain natriuretic peptide (1-76)
  • Natriuretic Peptide, Brain
  • Uric Acid
  • Nitric Oxide