Serum BNP and troponin-I as predictors of outcome in acute exacerbation of chronic obstructive pulmonary disease

Yadav DP, Singh M, Singh A, Prakash V, Srivastava GN

Pdf Page Numbers :- 83-87

Devendra Paratap Yadav¹, Mrityunjaya Singh^2,*, Anjana Singh³, Ved Prakash² and Govind Narayan Srivastava⁴

¹Department of Pulmonary Medicine, MPMMM Cancer Centre, Tata Medical Centre, Varanasi, UP - 221005

²Department of Pulmonary & Critical Care Medicine, King George’s Medical University, Lucknow, Uttar Pradesh 226003, India

³Department of Biochemistry, Era’s Medical University, Lucknow, Uttar Pradesh 226003, India

⁴Department of Respiratory Medicine, Institute of Medical Sciences, Varanasi, Uttar Pradesh 221005, India

*Corresponding author: Dr. Mrityunjaya Singh, MD., Department of Pulmonary & Critical Care Medicine, King George’s Medical University, Lucknow, Uttar Pradesh 226003, India. Email: dr.mrityunjaya@gmail.com

Received 14 October 2024; Revised 22 November 2024; Accepted 2 December 2024; Published 12 December 2024

Citation: Yadav DP, Singh M, Singh A, Prakash V, Srivastava GN. Serum BNP and troponin-I as predictors of outcome in acute exacerbation of chronic obstructive pulmonary disease. J Med Sci Res. 2025; 13(1):83-87. DOI: http://dx.doi.org/10.17727/JMSR.2024/13-14

Copyright: © 2025 Yadav DP et al. Published by KIMS Foundation and Research Center. This is an open-access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.

PDF

Abstract

Background: Acute exacerbation of chronic obstructive pulmonary disease (AECOPD) poses a major burden due to unpredictable outcomes, prolonged hospitalizations, and mortality risks. Identifying reliable prognostic markers is essential for better management. This study evaluates serum biomarkers—CRP, BNP, fibrinogen, and troponin I—as predictors of AECOPD outcomes to enhance clinical decision-making.

Methods: This was a single-centre, prospective, observational study involving 154 patients admitted with AECOPD to a tertiary care hospital between August 2022 and May 2024. Patients with pre-existing ischemic heart disease, recent myocardial infarction, severe renal or hepatic disease, or neuromuscular disorders were excluded. Biomarkers were measured at the time of admission, and patients were followed up to 90 days post-discharge. The primary endpoint was in-hospital mortality, while secondary endpoints included the need for intensive care and 90-day survival.

Results: Of the 154 patients enrolled, 18% (n=28) succumbed to their illness during hospitalization. The non-survivor group demonstrated significantly higher levels of BNP (mean: 1218.10 ± 559.35 pg/mL; p=0.018) and troponin I (mean: 0.45 ± 0.14 ng/mL; p<0.001) at admission compared to survivors. CRP levels were elevated in both groups but did not independently predict mortality (p=0.08). Fibrinogen levels were higher in non-survivors but were not statistically significant (p=0.187). Notably, BNP exhibited a strong positive correlation with prolonged hospital stay and intensive care requirements. Levels of BNP and fibrinogen normalized at 90-day follow-up in survivors, underscoring their role as acute-phase biomarkers. Troponin I remained elevated in non-survivors, highlighting its potential as a mortality predictor.

Conclusions: Serum BNP and troponin I predict in-hospital mortality and prolonged hospitalization in AECOPD, while CRP and fibrinogen have limited prognostic value. BNP correlates with disease severity, aiding risk stratification and intensive care decisions. Larger multi-center studies are needed to validate findings and develop comprehensive prognostic models for AECOPD management.

Keywords: AECOPD; biomarkers; BNP; troponin I; CRP; fibrinogen; mortality; hospital outcomes