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. 2024 Jun 4:19:1233-1245.
doi: 10.2147/COPD.S448496. eCollection 2024.

Predictive Value of Smoking Index Combined with NT-proBNP for Patients with Pulmonary Hypertension Due to Chronic Lung Disease: A Retrospective Study

Lin Sun #  1   2 , Xu Zhao  1 , Yunting Guo #  1 , Xiaomin Hou  3   4   5 , Jieru Li  6 , Xiaoxia Ren  7 , Lin Dong  1 , Ruifeng Liang  1 , Jisheng Nie  1 , Yiwei Shi  2 , Xiaojiang Qin  1   2   4   5   8
Affiliations

Predictive Value of Smoking Index Combined with NT-proBNP for Patients with Pulmonary Hypertension Due to Chronic Lung Disease: A Retrospective Study

Lin Sun et al. Int J Chron Obstruct Pulmon Dis. .

Abstract

Purpose: Smoking is a major risk factor for the group 3 PH. NT-proBNP is a biomarker for risk stratification in PH. This study aims to investigate the effects of smoking status and smoking index (SI) on group 3 PH and to evaluate the value of SI and SI combined with NT-proBNP in early diagnosis and prediction of disease severity.

Patients and methods: Four hundred patients with group 3 PH at the First Hospital of Shanxi Medical University between January 2020 and December 2021 were enrolled and divided into two groups: mild (30 mmHg ≤ pulmonary artery systolic pressure (PASP)≤50 mmHg) and non-mild (PASP >50 mmHg). The effect of smoking on group 3 PH was analyzed using univariate analysis, and logistic analysis was conducted to evaluate the risk of group 3 PH according to smoking status and SI. Spearman correlation coefficient was used to test the correlation between SI and the index of group 3 PH severity. The predictive value of SI was evaluated using a receiver operating characteristic (ROC) curve.

Results: Correlation and logistic analyses showed that SI was associated with PH severity. Smoking status (P=0.009) and SI (P=0.039) were independent risk factors for non-mild group 3 PH, and ROC showed that the predictive value of SI (AUC:0.596) for non-mild PH was better than that of the recognized pro-brain natriuretic peptide (NT-proBNP) (AUC:0.586). SI can be used as a single predictive marker. SI and NT-proBNP can be formulated as prediction models for screening non-mild clinical cases (AUC:0.628).

Conclusion: SI is a potentially ideal non-invasive predictive marker for group 3 PH. SI and NT-proBNP could be used to develop a prediction model for screening non-mild PH cases. This can greatly improve the predictive specificity of the established PH marker, NT-proBNP.

Keywords: NT-proBNP; chronic lung disease; predictive value; pulmonary hypertension; smoking index.

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Conflict of interest statement

The authors report no conflicts of interest in this work.

Figures

Figure 1
Figure 1
Study population. (A) Flow chart. (B) Distribution of PH patients in 5 groups.
Figure 2
Figure 2
Echocardiography of mild and non-mild group 3 PH patients with different smoking status. (A) 70 years old male non-smokers with mild symptoms had a PASP of 43. (B) 70 years old male non-smokers with non-mild symptoms had a PASP of 85. (C) 70 years old male smokers with mild symptoms had a PASP of 44. (D) 70 years old male smokers with non-mild symptoms had a PASP of 82.
Figure 3
Figure 3
Prediction value of SI in non-mild group 3 PH.
See this image and copyright information in PMC

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