Correlation Study Between Biomarkers With The Condition And Prognosis In Patients Of Pulmonary Arterial Hypertension

Part I Correlation Study Between Red Cell Distribution Width and the Condition and Prognosis in Patients with Chronic Thromboembolic Pulmonary HypertensionObjective:To explore the relationship between circulating red cell distribution width(RDW) and the condition and prognosis in patients with chronic thromboembolic pulmonary hypertension(CTEPH).Methods:A total of 66 consecutive CTEPH patients diagnosed by right heart catheterization or Echocardiography were enrolled in our work. Taking the cut-off value of RDW=14%, the patients were divided into 2 groups as RDW>14% group(n=21) and RDW≤14% group(n=45). The baseline profile was recorded and compared between 2 groups and the follow-up outcome was analyzed by ROC curves and Logistic regression survival analysis.Results:It is indicated that RDW level positively related to creatinine 、BNP and total bilirubin(r=0.258,P=0.037;r=0.263,P=0.033;r=0.356,P=0.030). ROC curve presented that compared with BNP and total bilirubin, RDW、BNP、total bilirubin were the effective predictor for all-cause mortality in CTEPH patients in ROC curve(P=0.002;P<0.001;P=0.006), the area under the curve were 0.734、0.806、0.713 respectively. Based on cut-off value of 14%, the sensitivity and specificity for RDW prediction in CTEPH mortality was 60% and 80% respectively. It showed that RDW≤14% group had better prognosis than RDW>14% group(P<0.001).Moreover, the levels of BNP、total bilirubin were higher in RDW>14% group than that in RDW≤14% group(P<0.05). It suggested that RDW>14% is an independent risk factor predicting death in CTEPH patients with Multi-Cox regression analysis.Conclusion:RDW level is reverse related to clinical condition and prognosis in CTEPH patients. Higher level of RDW is correlation with the severity and worse prognosis of disease, which was an independent risk factor for adverse events.Part II Correlation Study Between Neutrophil/Lymphocyte Ratio and the Condition and Prognosis in Patients with Pulmonary Arterial HypertensionObjective:To investigate clinical importance of neutrophil/lymphocyte ratio(NLR) in patients with pulmonary arterial hypertension(PAH).Methods:A total of 101 consecutive PAH patients with confirmed diagnosis of right heart catheterization or Echocardiography were enrolled in our work. According to ROC curve, Taking the cut-off value of NLR=2.23, the patients were divided into 2 groups as NLR>2.23 group, n=31 and RDW≤2.23 group, n=70. The baseline condition was recorded and compared between 2 groups and follow-up outcome was studied with Cox regression survival analysis. NLR、neutrophil count and Lymphocyte count were analyzed with independent t-test between survival group and dead group.Results:Compared the data of baseline between the two groups: BNP, C-reactive protein, total bilirubin from NLR> 2.23 group was higher than that from NLR≤2.23 group respectively(P <0.05). Kaplan-Meier survival curve showed better prognosis in NLR≤2.23 group(P = 0.011). Univariate COX regression survival analysis showed that hazard ratio of the two groups was 2.45(P = 0.014).Meanwhile NLR in dead group were higher than that in survival group(P = 0.007).Conclusion:It suggested that NLR may be a cost effective index to evaluate the clinical severity of PH and predict future risk.