Diagnostic and prognostic role of biomarkers for pulmonary hypertension in interstitial lung disease

SummaryBackgroundPulmonary hypertension (PH) is an important complication to interstitial lung disease (ILD). The aim of the present study was to investigate the relation of NT-proBNP, fibrin D-dimer, troponin-T, uric acid and exhaled nitric oxide (NO) to the presence of PH and mortality in ILD.MethodsIn a previously described cohort of 212 ILD patients of whom 29 had PH, levels of the above mentioned biomarkers were analyzed as routine tests.ResultsA value of NT-proBNP below 95 ng/l had a negative predictive value for PH of 99% (95% CI: 94–100). Values of troponin-T were higher in patients with PH (median (inter quartile range) = 9 (9–20) vs. 9(9–10) ng/l), and the odds ratio (OR) for PH was increased in patients with abnormal levels of uric acid (OR (95% CI) = 3.1(1.1–8.8)). NT-proBNP and troponin-T values above the 50th percentile, and uric acid and fibrin D-dimer values above the 90th percentile were each associated with increased mortality.ConclusionsA value of NT-proBNP below 95 ng/l may be used as a rule-out test for PH in ILD, while an abnormal value of uric acid is a risk factor for PH. NT-proBNP, troponin-T, uric acid and fibrin D-dimer have prognostic value in ILD patients, while exhaled levels of NO do not seem to predict PH or mortality.