Cardiac biomarkers retain prognostic significance in patients with heart failure and chronic obstructive pulmonary disease

Giuseppe Vergaro, Alberto Aimo*, James L. Januzzi, A. Mark Richards, Carolyn S.P. Lam, Roberto Latini, Lidia Staszewsky, Inder S. Anand, Thor Ueland, Hans Peter Brunner La Rocca, Antoni Bayes-Genis, Josep Lupón, Rudolf A. De Boer, Akiomi Yoshihisa, Yasuchika Takeishi, Ida Gustafsson, Kai M. Eggers, Kurt Huber, Greg D. Gamble, Kui Toh Gerard LeongPoh Shuan Daniel Yeo, Hean Yee Ong, Fazlur Jaufeerally, Tze P. Ng, Richard Troughton, Robert N. Doughty, Michele Emdin, Claudio Passino

*Corresponding author for this work

Research output: Contribution to journalArticleAcademicpeer-review

1 Citation (Scopus)


AimsChronic obstructive pulmonary disease (COPD) is a frequent comorbidity in patients with heart failure (HF). We assessed the influence of COPD on circulating levels and prognostic value of three HF biomarkers: N-Terminal pro-B-Type natriuretic peptide (NT-proBNP), high-sensitivity troponin T (hs-TnT), and soluble suppression of tumorigenesis-2 (sST2).MethodsIndividual data from patients with chronic HF, known COPD status, NT-proBNP and hs-TnT values (n = 8088) were analysed. A subgroup (n = 3414) had also sST2 values.ResultsPatients had a median age of 66 years (interquartile interval 57-74), 77% were men and 82% had HF with reduced ejection fraction. NT-proBNP, hs-TnT and sST2 were 1207 ng/l (487-2725), 17 ng/l (9-31) and 30 ng/ml (22-44), respectively. Patients with COPD (n = 1249, 15%) had higher NT-proBNP (P = 0.042) and hs-TnT (P < 0.001), but not sST2 (P = 0.165). Over a median 2.0-year follow-up (1.5-2.5), 1717 patients (21%) died, and 1298 (16%) died from cardiovascular causes; 2255 patients (28%) were hospitalized for HF over 1.8 years (0.9-2.1). NT-proBNP, hs-TnT and sST2 predicted the three end points regardless of COPD status. The best cut-offs from receiver-operating characteristics analysis were higher in patients with COPD than in those without. Patients with all three biomarkers higher than or equal to end-point-and COPD-status-specific cut-offs were also those with the worst prognosis.ConclusionsAmong patients with HF, those with COPD have higher NT-proBNP and hs-TnT, but not sST2. All these biomarkers yield prognostic significance regardless of the COPD status.

Original languageEnglish
Pages (from-to)28-36
Number of pages9
JournalJournal of Cardiovascular Medicine
Issue number1
Publication statusPublished - 1 Jan 2022
Externally publishedYes

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