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Meta-Analysis
. 2017 May;14(2):117-126.
doi: 10.1177/1479972316674393. Epub 2016 Dec 15.

Amino terminal pro brain natriuretic peptide predicts all-cause mortality in patients with chronic obstructive pulmonary disease: Systematic review and meta-analysis

Rita Pavasini  1 , Guido Tavazzi  2   3 , Simone Biscaglia  1 , Federico Guerra  4 , Alessandro Pecoraro  1 , Fatima Zaraket  1 , Francesco Gallo  1 , Giosafat Spitaleri  1 , Marco Contoli  5 , Roberto Ferrari  1   6   7 , Gianluca Campo  1   6   7
Affiliations
Meta-Analysis

Amino terminal pro brain natriuretic peptide predicts all-cause mortality in patients with chronic obstructive pulmonary disease: Systematic review and meta-analysis

Rita Pavasini et al. Chron Respir Dis. 2017 May.

Abstract

Natriuretic peptides (NPs) are a family of prognostic biomarkers in patients with heart failure (HF). HF is one of the most frequent comorbidities in patients with chronic obstructive pulmonary disease (COPD). However, the prognostic role of NP in COPD patients remains unclear. The aim of this meta-analysis was to evaluate the relation between NP and all-cause mortality in COPD patients. We performed a systematic review and meta-analysis of observational studies assessing prognostic implications of elevated NP levels on all-cause mortality in COPD patients. Nine studies were considered for qualitative analysis for a total of 2788 patients. Only two studies focused on Mid Regional-pro Atrial Natriuretic Peptide (MR-proANP) and brain natriuretic peptide (BNP), respectively, but seven studies focused on pro-BNP (NT-proBNP) and were included in the quantitative analysis. Elevated NT-proBNP values were related to increased risk of all-cause mortality in COPD patients both with and without exacerbation (hazard ratio (HR): 2.87, p < 0.0001 and HR: 3.34, p = 0.04, respectively). The results were confirmed also after meta-regression analysis for confounding factors (previous cardiovascular history, hypertension, HF, forced expiratory volume at 1 second and mean age). NT-proBNP may be considered a reliable predictive biomarker of poor prognosis in patients with COPD.

Keywords: Chronic obstructive pulmonary disease; NT-proBNP; exacerbation; mortality; outcome.

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Conflict of interest statement

Declaration of conflicting interests: The author(s) declared no potential conflicts of interest with respect to the research, authorship, and/or publication of this article.

Figures

Figure 1.
Figure 1.
Outline of search strategy. N: number.
Figure 2.
Figure 2.
Relationship between NT-proBNP above the cut-off and all-cause mortality. Data are displayed for each available study. Error bars represent 95% CIs. SE: standard error. CI: confidence interval.
Figure 3.
Figure 3.
Funnel plot of study included in the meta-analyses.
See this image and copyright information in PMC

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