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

Lin Sun, Xu Zhao, Yunting Guo, Xiaomin Hou, Jieru Li, Xiaoxia Ren, Lin Dong, Ruifeng Liang, Jisheng Nie, Yiwei Shi, Xiaojiang Qin
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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: smoking index, NT-proBNP, pulmonary hypertension, chronic lung disease, predictive value
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吸烟指数结合 NT-proBNP 对慢性肺病所致肺动脉高压患者的预测价值:一项回顾性研究
目的:吸烟是第 3 组 PH 的主要风险因素。NT-proBNP 是对 PH 进行风险分层的生物标志物。本研究旨在探讨吸烟状态和吸烟指数(SI)对3组PH的影响,并评估SI和SI联合NT-proBNP在早期诊断和预测疾病严重程度方面的价值:选取2020年1月至2021年12月期间在山西医科大学第一医院就诊的400例3组PH患者,将其分为两组:轻度组(30 mmHg ≤ 肺动脉收缩压(PASP)≤ 50 mmHg)和非轻度组(PASP > 50 mmHg)。采用单变量分析方法分析了吸烟对第 3 组 PH 的影响,并根据吸烟状况和 SI 进行了逻辑分析,以评估第 3 组 PH 的风险。Spearman 相关系数用于检验 SI 与 PH 第 3 组严重程度指数之间的相关性。使用接收器操作特征曲线(ROC)评估了SI的预测价值:相关分析和逻辑分析表明,SI 与 PH 严重程度相关。ROC显示,SI(AUC:0.596)对非轻度PH的预测价值优于公认的前脑钠尿肽(NT-proBNP)(AUC:0.586)。SI 可作为单一的预测指标。SI和NT-proBNP可作为筛查非轻度临床病例的预测模型(AUC:0.628):结论:SI 是第 3 组 PH 潜在的理想无创预测指标。结论:SI 是第 3 组 PH 潜在的理想无创预测标志物,SI 和 NT-proBNP 可用于开发筛查非轻度 PH 病例的预测模型。关键词:吸烟指数;NT-proBNP;肺动脉高压;慢性肺病;预测价值
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来源期刊
CiteScore
5.10
自引率
10.70%
发文量
372
审稿时长
16 weeks
期刊介绍: An international, peer-reviewed journal of therapeutics and pharmacology focusing on concise rapid reporting of clinical studies and reviews in COPD. Special focus will be given to the pathophysiological processes underlying the disease, intervention programs, patient focused education, and self management protocols. This journal is directed at specialists and healthcare professionals
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