Usefulness of mid regional pro-atrial natriuretic peptide in the exacerbations of chronic obstructive pulmonary disease

Clin Chim Acta. 2011 Feb 20;412(5-6):470-5. doi: 10.1016/j.cca.2010.11.032. Epub 2010 Dec 4.

Abstract

Background: A recent approach for the management of chronic obstructive pulmonary disease (COPD) is the measurement of systemic biomarkers. The aim of this study was to evaluate the usefulness of mid regional pro-atrial natriuretic peptide (MR-proANP) to predict short and long term prognosis.

Methods: We included 318 COPD patients: 46 in a stable phase, 217 undergoing an exacerbation and 55 with pneumonia. Serum samples were collected at admission. For 20 exacerbated patients, we also collected a second sample one month later. MR-proANP was measured by an inmunofluorescent assay.

Results: Statistically higher levels of MR-proANP were found in patients with pneumonia when comparing to patients in the stable state (p=0.031). For those patients with paired samples, MR-proANP decreased statistically one month later (p=0.027). MR-proANP showed significant lower levels in exacerbations with isolation of pathogenic bacteria (p=0.011). MR-proANP levels were higher in patients that died within one month, decreasing as long as the moment of death occurred later on (p=0.163).

Conclusions: The identification of exacerbation etiology by means of MR-proANP is not clinically reliable. Levels of MR-proANP vary depending on the clinical status, being higher during pneumonia in comparison to the stable state. MR-proANP levels were higher in patients that died within one month after the exacerbation episode.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Aged
  • Atrial Natriuretic Factor / analysis*
  • Atrial Natriuretic Factor / immunology
  • Female
  • Follow-Up Studies
  • Humans
  • Male
  • Pneumonia / diagnosis
  • Pneumonia / etiology
  • Prognosis
  • Pulmonary Disease, Chronic Obstructive / diagnosis*
  • Pulmonary Disease, Chronic Obstructive / etiology
  • Pulmonary Disease, Chronic Obstructive / immunology

Substances

  • Atrial Natriuretic Factor