For a study, researchers sought to examine the predictive value of (NT-pro)BNP in patients with pulmonary arterial hypertension (PAH). It consisted of both a systematic review and a meta-analysis. To find studies on the predictive value of baseline (NT-pro)BNP levels in PAH, a comprehensive search of the relevant published literature was conducted utilizing MEDLINE, Embase, Web of Science, the Cochrane Library, and Google scholar. Studies that reported hazard ratios (HR) for the endpoints of mortality or lung transplantation were considered eligible for inclusion. A meta-analysis with random effects was carried out so that the pooled HR of (NT-pro)BNP levels could be determined at the time of diagnosis. For studies that reported an HR based on a continuous (NT-pro)BNP measurement, the HR was measured for a 2-fold difference of the weighted mean (NT-pro)BNP level of 247 pmol/L. This was done to account for the fact that different transformations were applied to (NT-pro)BNP in the various studies. A total of 6,999 patients were represented across 16 studies (mean age 45.2-65.0 years, 97.3% PAH). In total, 1,460 patients reached the endpoint throughout the study’s mean follow-up period, which ranged from 1 to 10 years. The HRs based on cut-off values were reported in 9 different studies. Both elevated NT-proBNP and BNP were associated with an increased risk of mortality or lung transplant, with a pooled HR based on unadjusted HRs of 2.75 (95% CI: 1.86-4.07) 3.87 (95% CI: 2.69-5.57) respectively. On a continuous scale, the HRs for (NT-pro)BNP were reported in 6 different studies. With a pooled HR of 1.17 (95%-CI: 1.03-1.32), an increase in the risk of mortality or lung transplant was seen whenever there was a 2-fold difference in the weighted mean of NT-proBNP. Patients diagnosed with PAH with elevated levels of (NT-pro)BNP had a significantly increased likelihood of passing away or requiring a lung transplant.

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