Midregional Pro-A-Type Natriuretic Peptide and Carboxy-Terminal Provasopressin May Predict Prognosis in Community-Acquired Pneumonia

Masiá, Mar; Papassotiriou, Jana; Morgenthaler, Nils G.; Hernández, Imilla Casado; Shum, Conrado; Gutiérrez, Félix

doi:10.1373/clinchem.2007.085688

Cited by 48 publications

(33 citation statements)

References 35 publications

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“…(28) Although our study involved patients with VAP, our results show some similarities to data presented in these studies of CAP. (27,28) In our study, the levels of procalcitonin, MR-proANP, and copeptin were also significantly higher in the nonsurvivors.…”

Section: Discussionsupporting

confidence: 58%

“…(26) In another study, the PSI was found to correlate positively with MR-proANP level and copeptin level. (27) Those authors found that MR-proANP and copeptin levels were significantly higher in nonsurvivors than in survivors. In another study, involving 589 patients with proven CAP, the levels of MR-proANP, copeptin, CRP, and procalcitonin, as well as a mortality prediction score, were determined at admission.…”

Section: Discussionmentioning

confidence: 98%

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Comparação da acurácia de preditores de mortalidade na pneumonia associada à ventilação mecânica

Seligman

Teixeira

2011

J. bras. pneumol.

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Objective: Levels of procalcitonin, midregional pro-atrial natriuretic peptide (MR-proANP), C-terminal provasopressin (copeptin), and C-reactive protein (CRP), as well as Sequential Organ Failure Assessment (SOFA) scores, are associated with severity and described as predictors of outcome in ventilator-associated pneumonia (VAP). This study sought to compare the predictive value of these biomarkers for mortality in VAP. Methods: An observational study of 71 patients with VAP. Levels of procalcitonin, MR-proANP, copeptin, and CRP, together with SOFA scores, were determined at VAP onset, designated day 0 (D0), and on day 4 of treatment (D4). Patients received empirical antimicrobial therapy, with modifications based on culture results. Patients who died before D28 were classified as nonsurvivors. Results: Of the 71 patients evaluated, 45 were classified as survivors. Of the 45 survivors, 35 (77.8%) received appropriate antimicrobial therapy, compared with 18 (69.2%) of the 26 nonsurvivors (p = 0.57). On D0 and D4, the levels of all biomarkers (except CRP), as well as SOFA scores, were lower in eventual survivors than in eventual nonsurvivors. For D0 and D4, the area under the ROC curve was largest for procalcitonin. On D0, MR-proANP had the highest positive likelihood ratio (2.71) and positive predictive value (0.60), but procalcitonin had the highest negative predictive value (0.87). On D4, procalcitonin had the highest positive likelihood ratio (3.46), the highest positive predictive value (0.66), and the highest negative predictive value (0.93). Conclusions: The biomarkers procalcitonin, MR-proANP, and copeptin can predict mortality in VAP, as can the SOFA score. Procalcitonin alone has the greatest predictive power for such mortality.Keywords: Pneumonia, ventilator-associated/mortality; Biological markers/analysis; Health Status Indicators. ResumoObjetivo: Níveis de procalcitonina, midregional pro-atrial natriuretic peptide (MR-proANP, pró-peptídeo natriurético atrial midregional),, C-terminal provasopressin (copeptina), proteína C reativa (CRP) e escore do Sequential Organ Failure Assessment (SOFA) são associados a gravidade e descritos como preditores de desfechos na pneumonia associada a ventilação mecânica (PAVM). Este estudo procurou comparar o valor preditivo de mortalidade desses biomarcadores na PAVM. Métodos: Estudo observacional com 71 pacientes com PAVM. Níveis de procalcitonina, MR-proANP, copeptina e PCR, bem como escore de SOFA foram obtidos no dia do diagnóstico de PAVM, designado dia zero (D0), e no quarto dia de tratamento (D4) Os pacientes receberam tratamento antimicrobiano empírico, com modificações baseadas nos resultados de cultura. Os pacientes que morreram antes de D28 foram classificados como não sobreviventes. Resultados: Dos 71 pacientes, 45 sobreviveram. Dos 45 sobreviventes, 35 (77,8%) receberam tratamento antimicrobiano adequado, comparados com 18 (69,2%) dos 26 não sobreviventes (p = 0,57). Os sobreviventes apresentaram valores significativamente mais baixos em todos os b...

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Section: Discussionsupporting

confidence: 58%

Section: Discussionmentioning

confidence: 98%

Comparação da acurácia de preditores de mortalidade na pneumonia associada à ventilação mecânica

Seligman

Teixeira

2011

J. bras. pneumol.

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“…5 Second, these scoring systems can underestimate the potential severity of CAP in young patients. 32 Of the many possible laboratory biomarkers, several serum markers, such as D-dimer, 33 cortisol, 34 B-type natriuretic peptide, 35 mid-regional pro-atrial natriuretic peptide, 36 and copeptin 37 levels, correlate well with the clinical outcomes of patients with CAP. However, these parameters are unsuitable for routine use in patients with CAP due to the cost of the assays or the retrospective nature of the results.…”

Section: Discussionmentioning

confidence: 99%

Predictive Values of Semi-Quantitative Procalcitonin Test and Common Biomarkers for the Clinical Outcomes of Community-Acquired Pneumonia

Ugajin¹,

Yamaki²,

Hirasawa³

et al. 2013

Respir Care

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BACKGROUND:The semi-quantitative serum procalcitonin test (Brahms PCT-Q) is available conveniently in clinical practice. However, there are few data on the relationship between results for this semi-quantitative procalcitonin test and clinical outcomes of community-acquired pneumonia (CAP). We investigated the usefulness of this procalcitonin test for predicting the clinical outcomes of CAP in comparison with severity scoring systems and the blood urea nitrogen/serum albumin (B/A) ratio, which has been reported to be a simple but reliable prognostic indicator in our prior CAP study. METHODS: This retrospective study included data from subjects who were hospitalized for CAP from August 2010 through October 2012 and who were administered the semiquantitative serum procalcitonin test on admission. The demographic characteristics; laboratory biomarkers; microbiological test results; Pneumonia Severity Index scores; confusion, urea nitrogen, breathing frequency, blood pressure, > 65 years of age (CURB-65) scale scores; and age, dehydration, respiratory failure, orientation disturbance, pressure (A-DROP) scale scores on hospital admission were retrieved from their medical charts. The outcomes were mortality within 28 days of hospital admission and the need for intensive care. RESULTS: Of the 213 subjects with CAP who were enrolled in the study, 20 died within 28 days of hospital admission, and 32 required intensive care. Mortality did not differ significantly among subjects with different semi-quantitative serum procalcitonin levels; however, subjects with serum procalcitonin levels > 10.0 ng/mL were more likely to require intensive care than those with lower levels (P < .001). The elevation of semi-quantitative serum procalcitonin levels was more frequently observed in subjects with proven etiology, especially pneumococcal pneumonia. Using the receiver operating characteristic curves for mortality, the area under the curve was 0.86 for Pneumonia Severity Index class, 0.81 for B/A ratio, 0.81 for A-DROP, 0.80 for CURB-65, and 0.57 for semi-quantitative procalcitonin test. CONCLU-SIONS: The semi-quantitative serum procalcitonin level on hospital admission was less predictive of mortality from CAP compared with the B/A ratio. However, the subjects with serum procalcitonin levels > 10.0 ng/mL were more likely to require intensive care than those with lower levels.

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“…Whether CRP can be used for the etiological diagnosis of CAP has been extensively evaluated, but the results have been discordant [11,32,[34][35][36]. In the case of MR-proANP, there is no relationship with the etiology corroborating that MR-proANP levels reflect physiopathological dysfunction rather than etiology [16,37,38]. Regarding radiographic involvement, the PCT, CRP and neopterin levels were higher in patients with multilobar pneumonia, although in our previous experience, PCT correlated significantly with lobar involvement [6].…”

Section: Discussionmentioning

confidence: 99%

Usefulness of consecutive biomarkers measurement in the management of community-acquired pneumonia

Lacoma

Rodríguez

Prat

et al. 2011

Eur J Clin Microbiol Infect Dis

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The aim of this study was to investigate whether procalcitonin (PCT), neopterin, C-reactive protein (CRP), and mid regional pro-atrial natriuretic peptide (MR-proANP) levels at admission and during the clinical course can be useful for the management of patients with pneumonia. The study population consisted of 75 patients with clinical and radiological diagnosis of pneumonia. Serum samples were collected at admission and during hospitalization. Complications were defined as intensive care unit (ICU) admission or death. The levels of PCT were significantly higher in pneumonia of definite bacterial origin in comparison to probable bacterial or unknown origin. The PCT levels were higher in pneumococcal pneumonia. The PCT and MR-proANP levels increased significantly according to the Pneumonia Severity Index (PSI). All biomarkers levels are higher in patients developing complications and who were dying. The serial levels of MR-proANP remain significantly elevated in patients developing complications and in patients classified in PSI and CURB-65 risk groups. In patients not developing complications, there is a significant decrease in the PCT levels. PCT can be useful for identifying pneumonia etiology. PCT and MR-proANP levels correlate with pneumonia severity rules. PCT and MR-proANP serial measurements can be useful for predicting short-term prognosis. Systemic biomarkers can provide additional information regarding clinical evolution, because these are dynamic and can be measured daily.

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Midregional Pro-A-Type Natriuretic Peptide and Carboxy-Terminal Provasopressin May Predict Prognosis in Community-Acquired Pneumonia

Cited by 48 publications

References 35 publications

Comparação da acurácia de preditores de mortalidade na pneumonia associada à ventilação mecânica

Comparação da acurácia de preditores de mortalidade na pneumonia associada à ventilação mecânica

Predictive Values of Semi-Quantitative Procalcitonin Test and Common Biomarkers for the Clinical Outcomes of Community-Acquired Pneumonia

Usefulness of consecutive biomarkers measurement in the management of community-acquired pneumonia

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