Cardiac biomarkers in patients with isolated and combined course of chronic obstructive pulmonary disease and chronic heart failure

Abstract

The aim of the study was to define cardiac biomarkers in patients with isolated and combined chronic obstructive pulmonary disease (COPD) and chronic heart failure (CHF), to assess their level and diagnostic value in order to optimize the tactics of managing these patients. Materials and Methods. The study included 184 patients aged 38–85 years who were divided into 3 comparison groups: group 1 (n=68) was composed of patients with I–III stage COPD (GOLD, 2017); group 2 (n=64) patients with I–III functional class CHF; group 3 (n=52) patients with a combined course of COPD and CHF. Specific cardiac biomarkers were evaluated in 80 patients (in group 1 in 26, in group 2 in 27, and in group 3 in 27 patients). Patients’ blood serum obtained by centrifuging was used for cardiac biomarker investigations. Results. NT-proBNP (F=0.59; p=0.0490) was found to be the most sensitive biomarker for determining the severity degree of the heart damage in the combined course of COPD and CHF. ST2 biomarker reliably reflects the severity of the isolated CHF (F=0.76; p=0.0285), while in the combined course of COPD and CHF, the value of this marker decreases (F=0.76; p=0.4718). A direct correlation has been established between the level of cardiac biomarker NT-proBNP and CHF functional class both in the isolated and combined course of COPD and CHF. In patients highly adherent to therapy, statistically significant reduction in the values of ST2 (F=3.22; p=0.0453) and NT-proBNP (F=12.20; p=0.0000) is observed which enables the physicians to control patient adherence to the administered therapy. The levels of biomarkers have been established at which a high risk of COPD progressing to one step or higher and/or CHF to one functional class and higher is noted in comorbid COPD and CHF course. Conclusion. The obtained data about the diagnostic value of cardiac biomarkers in comorbid course of COPD and CHF is reasonable to use for therapy optimization in order to improve the quality of patient’s life and decrease the risk of unfavorable outcomes.