<br>中区域心房前自然肽（MRproANP）和和肽素（COPAVP）是最近诊断的轻度至中度 COPD 全因死亡率的预测因子——来自 COSYCONET 的结果,Respiratory Research

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中区域心房前自然肽（MRproANP）和和肽素（COPAVP）是最近诊断的轻度至中度 COPD 全因死亡率的预测因子——来自 COSYCONET 的结果
Respiratory Research ( IF 4.7 ) Pub Date : 2024-01-24 , DOI: 10.1186/s12931-024-02690-9
S Fähndrich ₁ , C Herr ₂ , S Teuteberg ₁ , P Alter ₃ , S Söhler ₃ , D Soriano ₁ , J Classen ₂ , J Adams ₂ , V Weinhold ₂ , H Watz ₄ , B Waschki _{5,

6,

7} , T Zeller _{7,

8} , M Eichenlaub ₉ , F C Trudzinski ₁₀ , J D Michels ₁₀ , A Omlor ₂ , F Seiler ₂ , I Moneke ₁₁ , F Biertz ₁₂ , D Stolz ₁ , T Welte ₁₃ , H U Kauczor ₁₄ , K Kahnert ₁₅ , R A Jörres ₁₆ , C F Vogelmeier _{3,

4} , R Bals _{2,

17} ,

Affiliation

Department of Pneumology, Faculty of Medicine, Medical Center, University of Freiburg, Killianstrasse 5, 79106, Freiburg, Germany.
Department of Internal Medicine V - Pulmonology, Allergology, Critical Care Care Medicine, Saarland University Hospital, Homburg, Germany.
Department of Medicine, Pulmonary, Critical Care and Sleep Medicine, Philipps University of Marburg (UMR), German Center for Lung Research (DZL), Marburg, Germany.
Airway Research Center North (ARCN), Pulmonary Research Institute at LungenClinic Grosshansdorf, Grosshansdorf, DZ, Germany.
LungenClinic Grosshansdorf, Member of the German Center for Lung Research (DZL), Airway Research Center North (ARCN), Grosshansdorf, Germany.
Pneumology, Hospital Itzehoe, Itzehoe, Germany.
University Heart & Vascular Center Hamburg, Department of Cardiology, University Medical Center Hamburg-Eppendorf, Hamburg, Germany.
German Center for Cardiovascular Research (DZHK), Partner Site Hamburg/Kiel/Lübeck, Hamburg, Germany.
Department of Cardiology and Angiology, Medical Center, University of Freiburg, Freiburg, Germany.
Department of Pneumology and Critical Care, Heidelberg, Translational Lung Research Center Heidelberg (TLRC-H), Member of the German Center for Lung Research (DZL), Thoraxklinik Heidelberg gGmbH, Heidelberg, Germany.
Department of Thoracic Surgery, Faculty of Medicine, Medical Center-University of Freiburg, University of Freiburg, Freiburg, Germany.
Institute for Biostatistics, Hannover Medical School, Hannover, Germany.
Department of Respiratory Medicine, Research in Endstage and Obstructive Lung Disease Hannover (BREATH), Hannover, Member of the German Center for Lung Research (DZL), Hannover Medical School, Hannover, Germany.
Diagnostic and Interventional Radiology, Member of the German Center of Lung Research, University Hospital Heidelberg, Heidelberg, Germany.
Department of Internal Medicine V, Comprehensive Pneumology Center, Member of the German Center for Lung Research (DZL), LMU University Hospital, LMU Munich, Ludwig-Maximilians-University Munich (LMU), Munich, Germany.
Institute and Outpatient Clinic for Occupational, Social and Environmental Medicine, Munich, Germany.
Helmholtz Institute for Pharmaceutical Research Saarland (HIPS), Helmholtz Centre for Infection Research (HZI), Saarland University Campus, Saarbrücken, Germany.

MRproANP 和 COPAVP 是慢性阻塞性肺疾病（COPD）死亡的预后标志物。此外，这些生物标志物可预测心血管疾病导致的死亡率，这是决定 COPD 患者合并症的重要预后。然而，对最近诊断的轻度至中度 COPD 的这些生物标志物知之甚少。因此，我们分析了这些生物标志物作为最近诊断的轻度至中度 COPD 死亡率的潜在预测因子。考虑的血液生物标志物是和肽素（COPAVP）、中区域肾上腺髓质素（MRproADM）、中区域心房前自然肽（MRproANP）和纤维蛋白原。对定义为 GOLD 0-2 级的稳定“最近诊断为轻度至中度 COPD”且在纳入 COSYCONET 队列前 ≤5 年诊断为 COPD 的患者进行分析（COPD 和全身后果 - 合并症网络），使用 Cox 回归分析逐步调整多种 COPD 特征、合并症、肌钙蛋白和 NT-proBNP。纳入 655 例最近诊断为轻度至中度 COPD 的患者。在初始回归模型中，655 名患者中有 43 名在 6 年随访期间死亡，最终模型 487 名患者中有 27 名死亡。调整混杂因素的回归分析发现，COPAVP 和 MRproANP 是全因死亡率的统计学稳健生物标志物（p < 0.05），而 MRproADM 和纤维蛋白原则不是。MRproANP 的第四个四分位数（97 pmol/L）的风险比为 4.5 （95%CI： 1.6;12.8），COPAVP 的第四个四分位数（9.2 pmol/L）为 3.0 （1.1;8.0）。MRproANP 的结果在 0-4 级的总队列中得到证实（n = 1470 最终）。在最近诊断为轻度至中度 COPD 的患者中，在调整多种其他因素后，COPVP 值升高，尤其是 MRproANP 是全因死亡风险的稳健、独立的生物标志物。这表明这些标志物可能在早期 COPD 的风险评估中被考虑。

"点击查看英文标题和摘要"

Midregional proatrial naturetic peptide (MRproANP) and copeptin (COPAVP) as predictors of all-cause mortality in recently diagnosed mild to moderate COPD—results from COSYCONET

MRproANP and COPAVP are prognostic markers for mortality in chronic obstructive pulmonary disease (COPD). Furthermore, these biomarkers predict mortality due to cardiovascular diseases, which are important prognostically determining comorbidities in patients with COPD. However, less is known about these biomarkers in recently diagnosed mild to moderate COPD. Therefore, we analyzed these biomarkers as potential predictors of mortality in recently diagnosed mild to moderate COPD. The blood biomarkers considered were copeptin (COPAVP), midregional adrenomedullin (MRproADM), midregional proatrial naturetic peptide (MRproANP), and fibrinogen. Analyses were performed in patients with stable “recently diagnosed mild to moderate COPD” defined by GOLD grades 0–2 and diagnosis of COPD ≤ 5 years prior to inclusion into the COSYCONET cohort (COPD and Systemic Consequences—Comorbidities Network), using Cox regression analysis with stepwise adjustment for multiple COPD characteristics, comorbidities, troponin and NT-proBNP. 655 patients with recently diagnosed mild to moderate COPD were included. In the initial regression model, 43 of 655 patients died during the 6-year follow-up, in the final model 27 of 487. Regression analyses with adjustment for confounders identified COPAVP and MRproANP as statistically robust biomarkers (p < 0.05 each) of all-cause mortality, while MRproADM and fibrinogen were not. The fourth quartile of MRproANP (97 pmol/L) was associated with a hazard ratio of 4.5 (95%CI: 1.6; 12.8), and the fourth quartile of COPAVP (9.2 pmol/L) with 3.0 (1.1; 8.0). The results for MRproANP were confirmed in the total cohort of grade 0–4 (n = 1470 finally). In patients with recently diagnosed mild to moderate COPD, elevated values of COPVP and in particular MRproANP were robust, independent biomarkers for all-cause mortality risk after adjustment for multiple other factors. This suggests that these markers might be considered in the risk assessment of early COPD.

更新日期：2024-01-25

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