Expression and Predictive Value of Angiopoietin-2 in Pulmonary Hypertension Associated with Chronic Obstructive Pulmonary Disease.

Abstract

Clear and effective treatment for pulmonary hypertension (PH) caused by chronic obstructive pulmonary disease (COPD) has not been established, and thus promptly identifying patients with PH is of particular importance. In this study, by comparing Angiopoietin-2 expression in patients with COPD and COPD-PH, we analysed the risk factors of PH and evaluated the predictive value of these in PH. Therefore, this prospective study selected COPD of patients as research subjects, which were divided into COPD and COPD-PH groups according to whether they were complicated with PH. Lung function, general laboratory index, N-terminal pro brain b-type natriuretic peptide (NT-proBNP), Angiopoietin-2, and other cytokines levels were compared between the two groups, and the risk factors of COPD-PH were explored through multivariate binary regression analysis. Lastly, receiver operating characteristic curve was used in evaluating the predictive value of risk factors for COPD-PH. The results show that the COPD-PH group has higher Angiopoietin-2, logistic analysis showed that Angiopoietin-2, NT-proBNP, age, and FEV1%pred were independent risk factors for COPD-PH and had high predictive value for COPD-PH. The AUROC for Angiopoietin-2 and NT-proBNP for predicting COPD-PH were 0.646 and 0.751. When Angiopoietin-2 ≥ 39.55 pg/ml, NT-proBNP ≥ 134.03 pg/ml, the sensitivity for COPD-PH prediction was 44.7 and 93.6%, respectively, and the specificity rates were 83.1 and 49.2%, respectively. When Angiopoietin-2 was combined with NT-proBNP, enhanced the AUROC to 0.766, exceeding Angiopoietin-2 alone, which may be useful in the prediction of COPD-PH.