Diagnostic and Prognostic Value of Plasma Adrenomedullin in COPD Exacerbation

Meng, Daquan; Li, Xiaojuan; Song, Xubin; Xin, Jian-Bao; Yang, Wei‐Bing

doi:10.4187/respcare.03046

Cited by 11 publications

(7 citation statements)

References 32 publications

(32 reference statements)

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“…MR-proADM is a promising biomarker21–23 that has been actively investigated as a tool to improve risk stratification in COPD patients 11,18,24. During COPD exacerbations, MR-proADM levels increase,11,24 suggesting that it could be of special interest in that specific context. In the current study, we confirmed previous reports,11,24 showing that MR-proADM levels on admission are higher in patients with subsequently worse outcomes.…”

Section: Discussionmentioning

confidence: 99%

“…During COPD exacerbations, MR-proADM levels increase,11,24 suggesting that it could be of special interest in that specific context. In the current study, we confirmed previous reports,11,24 showing that MR-proADM levels on admission are higher in patients with subsequently worse outcomes. Even after adjustment for the clinical risk score category, MR-proADM remained independently associated with outcomes at 7 and 30 days.…”

Section: Discussionmentioning

confidence: 99%

“…However, MR-proADM levels were only a moderate strong predictor of short-term outcomes. In contrast, MR-proADM has previously been established as a powerful predictor of long-term risk of death in COPD patients 18,24,25. One hypothesis to explain this discrepancy is that the value of MR-proADM as a predictor of short-term outcomes during exacerbations could be influenced by the etiology/phenotype of the event,26 the severity/phenotype of the underlying disease and/or the presence of comorbidities, all of which being known determinants of outcomes 14,27.…”

Section: Discussionmentioning

confidence: 99%

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Mid-regional pro-adrenomedullin and copeptin to predict short-term prognosis of COPD exacerbations: a multicenter prospective blinded study

Dres¹,

Hausfater²,

Foissac³

et al. 2017

COPD

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BackgroundExacerbations of COPD (ECOPD) are a frequent cause of emergency room (ER) visits. Predictors of early outcome could help clinicians in orientation decisions. In the current study, we investigated whether mid-regional pro-adrenomedullin (MR-proADM) and copeptin, in addition to clinical evaluation, could predict short-term outcomes.Patients and methodsThis prospective blinded observational study was conducted in 20 French centers. Patients admitted to the ER for an ECOPD were considered for inclusion. A clinical risk score was calculated, and MR-proADM and copeptin levels were determined from a venous blood sample. The composite primary end point comprised 30-day death or transfer to the intensive care unit or a new ER visit.ResultsA total of 379 patients were enrolled in the study, of whom 277 were eventually investigated for the primary end point that occurred in 66 (24%) patients. In those patients, the median (interquartile range [IQR]) MR-proADM level was 1.02 nmol/L (0.77–1.48) versus 0.83 nmol/L (0.63–1.07) in patients who did not meet the primary end point (P=0.0009). In contrast, copeptin levels were similar in patients who met or did not meet the primary end point (P=0.23). MR-proADM levels increased with increasing clinical risk score category: 0.74 nmol/L (0.57–0.89), 0.83 nmol/L (0.62–1.12) and 0.95 nmol/L (0.75–1.29) for the low-, intermediate- and high-risk categories, respectively (P<0.001). MR-proADM was independently associated with the primary end point (odds ratio, 1.65; 95% confidence interval [CI], 1.10–2.48; P=0.015). MR-proADM predicted the occurrence of primary end point with a sensitivity of 46% (95% CI, 33%–58%) and a specificity of 79% (95% CI, 74–84).ConclusionMR-proADM but not copeptin was significantly associated with outcomes at 30 days, even after adjustment for clinical risk category. Overall, MR-proADM, alone or combined with the clinical risk score, was a moderate strong predictor of short-term outcomes.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

See 1 more Smart Citation

Mid-regional pro-adrenomedullin and copeptin to predict short-term prognosis of COPD exacerbations: a multicenter prospective blinded study

Dres¹,

Hausfater²,

Foissac³

et al. 2017

COPD

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“…The MRM-MS approach, although previously applied to other disease states [ 14 , 27 , 28 ], marks a departure from traditional methods of biomarker research in AECOPD. Previous attempts at identifying biomarkers have relied on known proteins with available immunoassay platforms, for instance CRP, IL-6, angiopoietin-2, adrenomedullin, and troponin [ 6 , 29 – 32 ]. Unfortunately, proteins lacking commercial immunoassays may be overlooked by this strategy.…”

Section: Discussionmentioning

confidence: 99%

COPD Exacerbation Biomarkers Validated Using Multiple Reaction Monitoring Mass Spectrometry

et al. 2016

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BackgroundAcute exacerbations of chronic obstructive pulmonary disease (AECOPD) result in considerable morbidity and mortality. However, there are no objective biomarkers to diagnose AECOPD.MethodsWe used multiple reaction monitoring mass spectrometry to quantify 129 distinct proteins in plasma samples from patients with COPD. This analytical approach was first performed in a biomarker cohort of patients hospitalized with AECOPD (Cohort A, n = 72). Proteins differentially expressed between AECOPD and convalescent states were chosen using a false discovery rate <0.01 and fold change >1.2. Protein selection and classifier building were performed using an elastic net logistic regression model. The performance of the biomarker panel was then tested in two independent AECOPD cohorts (Cohort B, n = 37, and Cohort C, n = 109) using leave-pair-out cross-validation methods.ResultsFive proteins were identified distinguishing AECOPD and convalescent states in Cohort A. Biomarker scores derived from this model were significantly higher during AECOPD than in the convalescent state in the discovery cohort (p<0.001). The receiver operating characteristic cross-validation area under the curve (CV-AUC) statistic was 0.73 in Cohort A, while in the replication cohorts the CV-AUC was 0.77 for Cohort B and 0.79 for Cohort C.ConclusionsA panel of five biomarkers shows promise in distinguishing AECOPD from convalescence and may provide the basis for a clinical blood test to diagnose AECOPD. Further validation in larger cohorts is necessary for future clinical translation.

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“…The several effects, such as neuro-hormonal compensatory channel on target organs, gives it its wide biological activity, it is suggested that ADM acts as a powerful protective factor for the organism in situations of cellular stress, using mechanism diuresis and natriuresis, or contributing with the fight against infection, among others [4,8]. The relevance of the ADM is based on plasma concentrations of MR-proADM in humans, it has been shown to be increased in the course of major life-threatening diseases (sepsis, pneumonia, chronic obstructive pulmonary disease, myocardial infarction and heart failure), combining as counter-regulatory mechanism [9], and being very useful in risk stratification as it has been able to predict mortality in patients with these critical processes [5,[10][11][12][13][14][15].…”

Section: Discussionmentioning

confidence: 99%

Mid-Regional Proadrenomedullin as a Prognosis Biomarker of Mortality in Patients Treated with Non-Invasive Ventilation in the Emergency Room

Zapata¹

2017

Int J Crit Care Emerg Med

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Diagnostic and Prognostic Value of Plasma Adrenomedullin in COPD Exacerbation

Cited by 11 publications

References 32 publications

Mid-regional pro-adrenomedullin and copeptin to predict short-term prognosis of COPD exacerbations: a multicenter prospective blinded study

Mid-regional pro-adrenomedullin and copeptin to predict short-term prognosis of COPD exacerbations: a multicenter prospective blinded study

COPD Exacerbation Biomarkers Validated Using Multiple Reaction Monitoring Mass Spectrometry

Mid-Regional Proadrenomedullin as a Prognosis Biomarker of Mortality in Patients Treated with Non-Invasive Ventilation in the Emergency Room

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