Evaluation of mid-regional pro-atrial natriuretic peptide, procalcitonin, and mid-regional pro-adrenomedullin for the diagnosis and risk stratification of dyspneic ED patients

Çınar, Orhan; Çevik, Erdem; Acar, A.; Kaya, Cengiz; Ardıç, Şükrü; Cömert, Bilgin; Yokuşoğlu, Mehmet; Bilgi, Cumhur; Meisner, Michael; Madsen, Troy

doi:10.1016/j.ajem.2012.04.009

Cited by 24 publications

(19 citation statements)

References 20 publications

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“…ADM also has diagnostic and prognostic value alongside the natriuretic peptides in acute dyspnoea and in chronic heart failure (12)(13)(14)(15)(16)(17)(18)(19)(20), and in diastolic dysfunction (21). In post-AMI patients with new heart failure (9), patients with established heart failure (12,22), and patients presenting with acute dyspnoea in emergency settings (13)(14)(15)23), MRproADM has been shown to have independent prognostic significance for major adverse cardiovascular outcomes. It is also predictive of adverse outcomes in community patients with symptoms of heart failure (24).…”

Section: Discussionmentioning

confidence: 99%

Prognostic Significance of Adrenomedullin in Patients With Heart Failure and With Myocardial Infarction

Yuyun

Narayan

2015

The American Journal of Cardiology

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Highlights-This systematic review shows that adrenomedullin is an independent predictor of death in patients with heart failure, as well as MACE and death in patients who have suffered an acute myocardial infarction.-Quantification of this peptide might contribute to improved risk stratification in settings of heart failure and myocardial infarction. ABSTRACTWe undertook this systematic review to determine the prognostic significance of adrenomedullin (ADM) in heart failure and acute myocardial infarction (AMI) patients.Given the difficulty in measuring mature ADM, its surrogate, mid-regional proadrenomedullin (MRproADM), has been used in most studies. 1 nmol/l increase in MRproADM was associated with HR for MACE ranging from 1.78 to 4.10 (CI 1.20 -10.12), while log10 of MRproADM had hazard ratios of 3.63 to 9.75 ) for death across studies in AMI patients. In conclusion, adrenomedullin is an independent predictor of death in patients with heart failure, as well as MACE and death in patients who have suffered an AMI. Quantification of this peptide might contribute to improved risk stratification in settings of heart failure and myocardial infarction.

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Section: Discussionmentioning

confidence: 99%

Prognostic Significance of Adrenomedullin in Patients With Heart Failure and With Myocardial Infarction

Yuyun

Narayan

2015

The American Journal of Cardiology

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“…mortality predictor in patients with a variety of underlying diseases presenting to the ED with acute dyspnea [20][21][22][23][24][25][26] and, especially, in patients with CAP [13,[27][28][29][30][31][32][33][34][35][36][37][38]; key studies are summarized in Table 1. Many of the dyspnea and CAP studies [20-23, 25-27, 29-31] had cohorts comprising > 25% of patients with COPD as a cormorbidity.…”

Section: Proadm In the Risk Assessment Of Patients With Other Pulmonamentioning

confidence: 99%

“…Many of the dyspnea and CAP studies [20-23, 25-27, 29-31] had cohorts comprising > 25% of patients with COPD as a cormorbidity. Collectively, the published studies in these settings have had more ethnically and, particularly, geographically diverse samples than did the published ProADM studies focusing on COPD; whereas the latter have taken place overwhelmingly in Caucasian patients and exclusively in Europe, the dyspnea and CAP investigation has in aggregate included more non-white individuals, and in some cases, occurred partly or entirely in North America [21,23,24,28], Asia [25], or Oceania [21,23]. Vital status followup durations in these studies ranged from the hospital stay to 4 years.…”

Section: Proadm In the Risk Assessment Of Patients With Other Pulmonamentioning

confidence: 99%

“…There exists a substantial observational literature regarding ProADM use as an all-cause mortality predictor in patients with sepsis [11][12][13][14][15][16][17][18][19], in patients with a variety of underlying diseases presenting to the emergency department (ED) with acute dyspnea [20][21][22][23][24][25][26], and especially in patients with community-acquired pneumonia (CAP) [13,[27][28][29][30][31][32][33][34][35][36][37][38].…”

Section: Introductionmentioning

confidence: 99%

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The prognostic blood biomarker proadrenomedullin for outcome prediction in patients with chronic obstructive pulmonary disease (COPD): a qualitative clinical review

Schuetz¹,

Marlowe²,

Müeller

2015

Clinical Chemistry and Laboratory Medicine (CCLM)

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Plasma proadrenomedullin (ProADM) is a blood biomarker that may aid in multidimensional risk assessment of patients with chronic obstructive pulmonary disease (COPD). Co-secreted 1:1 with adrenomedullin (ADM), ProADM is a less biologically active, more chemically stable surrogate for this pluripotent regulatory peptide, which due to biological and ex vivo physical characteristics is difficult to reliably directly quantify. Upregulated by hypoxia, inflammatory cytokines, bacterial products, and shear stress and expressed widely in pulmonary cells and ubiquitously throughout the body, ADM exerts or mediates vasodilatory, natriuretic, diuretic, antioxidative, anti-inflammatory, antimicrobial, and metabolic effects. Observational data from four separate studies totaling 1366 patients suggest that as a single factor, ProADM is a significant independent, and accurate, long-term allcause mortality predictor in COPD. This body of work also suggests that combined with different groups of demographic/clinical variables, ProADM provides significant incremental long-term mortality prediction power relative to the groups of variables alone. Additionally, the literature contains indications that ProADM may be a global cardiopulmonary stress marker, potentially supplying prognostic information when cardiopulmonary exercise testing results such as 6-min walk distance are unavailable due to time or other resource constraints or to a patient's advanced disease. Prospective, randomized, controlled interventional studies are needed to demonstrate whether ProADM use in risk-based guidance of site-of-care, monitoring, and treatment decisions improves clinical, qualityof-life, or pharmacoeconomic outcomes in patients with COPD.

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“…Recently, several pro-hormone-type biomarkers have been studied and exhibit promising results for the risk stratification in various clinical situations associated with dyspnea: sepsis, acute coronary syndrome, CAP, AECOPD, and AHF (Cinar et al, 2012;de Kruif et al, 2010;Guignant et al, 2009;Hausfater et al, 2007;Khan et al, 2007;Krüger et al, 2010aKrüger et al, , 2010bMaisel et al, 2012Maisel et al, , 2010Melander et al, 2009;Neuhold et al, 2010;Peacock et al, 2011;Potocki et al, 2009;Shah et al, 2012;Stolz et al, 2008;Travaglino et al, 2014). These biomarkers comprise procalcitonin (PCT), midregional pro-A-Type natriuretic (MR-proANP), midregional proadrenomedullin (MR-proADM), pro-vasopressin (AVP, copeptin) and pro-endothelin1 (CT-proET1).…”

Section: Introductionmentioning

confidence: 99%

Prognostic value of PCT, copeptin, MR-proADM, MR-proANP and CT-proET-1 for severe acute dyspnea in the emergency department: the BIODINER study

Hausfater¹,

Claessens²,

Martinage³

et al. 2016

Biomarkers

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Three hundred and ninety-four patients were included, 137 (35%) met the primary endpoint. MR-proADM was the only biomarker associated with the primary endpoint (odds ratio 1.43 [95%CI: 1.13-1.82], p = 0.003) as were the presence of paradoxical abdominal breathing (odds ratio 2.48 [95%CI: 1.31-4.68]) or cyanosis (odds ratio 3.18 [1.46-6.89]) Conclusions: In patients with severe acute dyspnea in the ED, pro-hormone type biomarkers measurements have a low added value to clinical signs for the prediction of poor outcome.

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Evaluation of mid-regional pro-atrial natriuretic peptide, procalcitonin, and mid-regional pro-adrenomedullin for the diagnosis and risk stratification of dyspneic ED patients

Cited by 24 publications

References 20 publications

Prognostic Significance of Adrenomedullin in Patients With Heart Failure and With Myocardial Infarction

Prognostic Significance of Adrenomedullin in Patients With Heart Failure and With Myocardial Infarction

The prognostic blood biomarker proadrenomedullin for outcome prediction in patients with chronic obstructive pulmonary disease (COPD): a qualitative clinical review

Prognostic value of PCT, copeptin, MR-proADM, MR-proANP and CT-proET-1 for severe acute dyspnea in the emergency department: the BIODINER study

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