Photo Credit: Mr. Suphachai Praserdumrongchai

The following is a summary of “Midregional pro atrial naturetic peptide (MRproANP) and copeptin (COPAVP) as predictors of all-cause mortality in recently diagnosed mild to moderate COPD—results from COSYCONET,” published in the January 2024 issue of Pulmonology by Fähndrich et al.

Midregional pro atrial naturetic peptide (MRproANP) and copeptin (COPAVP) have shown promise as prognostic indicators for mortality in chronic obstructive pulmonary disease (COPD), especially concerning cardiovascular-related mortality, a significant concern in COPD patients. However, their utility in recently diagnosed mild to moderate COPD remains less explored. 

This study aimed to investigate the potential of these biomarkers as predictors of mortality in this specific COPD population.

In this analysis, the researchers assessed the blood biomarkers copeptin (COPAVP), midregional adrenomedullin (MRproADM), mid regional pro atrial naturetic peptide (MRproANP), and fibrinogen in patients with stable “recently diagnosed mild to moderate COPD,” defined by GOLD grades 0–2 and diagnosis of COPD ≤ 5 years before inclusion in the COSYCONET cohort (COPD and Systemic Consequences—Comorbidities Network). Cox regression analysis, with stepwise adjustment for multiple COPD characteristics, comorbidities, and other relevant factors, was utilized.

About 655 patients with recently diagnosed mild to moderate COPD were included in the study. Of these, 43 patients died during the 6-year follow-up period. After adjusting for confounders, COPAVP and MRproANP emerged as statistically significant biomarkers for all-cause mortality risk (P < 0.05 for each). Specifically, elevated levels of MRproANP in the fourth quartile (97 pmol/L) were associated with a HR of 4.5 (95% CI: 1.6; 12.8), while the fourth quartile of COPAVP (9.2 pmol/L) showed a HR  of 3.0 (1.1; 8.0). These findings were consistent in the total cohort of grades 0–4 (n = 1470).

In patients with recently diagnosed mild to moderate COPD, elevated levels of COPAVP and, notably, MRproANP were identified as robust, independent biomarkers for all-cause mortality risk, even after adjusting for various factors. These findings suggest the potential utility of these biomarkers in risk assessment for early-stage COPD patients.

 Source: respiratory-research.biomedcentral.com/articles/10.1186/s12931-024-02690-9