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- Title
Prognostic Significance of Biomarkers in Pulmonary Arterial Hypertension.
- Authors
Al-Naamani, Nadine; Palevsky, Harold I.; Lederer, David J.; Horn, Evelyn M.; Mathai, Stephen C.; Roberts, Kari E.; Tracy, Russell P.; Hassoun, Paul M.; Girgis, Reda E.; Shimbo, Daichi; Post, Wendy S.; Kawut, Steven M.; ASA-STAT Study Group
- Abstract
<bold>Rationale: </bold>Pulmonary arterial hypertension (PAH) is a rare progressive disease of the pulmonary vasculature that is characterized by endothelial dysfunction, inflammation, and right ventricular dysfunction.<bold>Objectives: </bold>The main objective was to determine whether endothelial, inflammatory, and cardiac biomarkers would be associated with the World Health Organization functional assessment and survival in patients with PAH.<bold>Methods: </bold>We performed a retrospective cohort study of patients with PAH enrolled in the Randomized Clinical Trial of Aspirin and Simvastatin for Pulmonary Arterial Hypertension (ASA-STAT). Biomarkers (N-terminal fragment of pro-BNP [NT-pro-BNP], von Willebrand factor [vWF], soluble P selectin, C-reactive protein, total and high-density lipoprotein cholesterol, triglycerides, tumor necrosis factor, IL-6, β-thromboglobulin, and thromboxane B2) were measured at baseline. Patients from the study were followed until lung transplantation, death, or August 1, 2013. Ordinal logistic regression and Cox regression analyses were performed.<bold>Measurements and Main Results: </bold>Sixty-five patients with PAH were enrolled. The mean age was 51 years, and 86% were women. Higher vWF activity, lower high-density lipoprotein cholesterol, and higher thromboxane B2 levels were associated with worse World Health Organization functional class after adjustment for age, sex, and etiology of PAH. Higher NT-pro-BNP levels, lower vWF activity, and lower total cholesterol were associated with an increased risk of death or lung transplant after adjustment for age, sex, etiology of PAH, and 6-minute-walk distance.<bold>Conclusions: </bold>In patients with PAH, lower vWF activity and cholesterol levels and higher NT-pro-BNP levels at baseline were associated with an increased risk of death or transplantation. Clinical trial registered with www.clinicaltrials.gov (NCT00384865).
- Subjects
PULMONARY hypertension treatment; PULMONARY hypertension diagnosis; BLOOD coagulation factors; BLOOD proteins; C-reactive protein; COMPARATIVE studies; EXERCISE tests; GLOBULINS; HIGH density lipoproteins; INTERLEUKINS; LUNG transplantation; RESEARCH methodology; MEDICAL cooperation; PEPTIDE hormones; PEPTIDES; PROGNOSIS; PULMONARY hypertension; RESEARCH; RESEARCH funding; PULMONARY function tests; SURVIVAL analysis (Biometry); EVALUATION research; RANDOMIZED controlled trials; PREDICTIVE tests; RETROSPECTIVE studies
- Publication
Annals of the American Thoracic Society, 2016, Vol 13, Issue 1, p25
- ISSN
2329-6933
- Publication type
journal article
- DOI
10.1513/AnnalsATS.201508-543OC