Pro-adrenomedullin as a Novel Biomarker for Predicting Infections and Response to Antimicrobials in Febrile Patients With Hematologic Malignancies

Shuaibi, Munirah Al; Bahu, Ramez; Chaftari, Anne-Marie; Wohoush, Iba Al; Shomali, William; Jiang, Ying; Debiane, Labib; Raad, Sammy; Jabbour, Joseph; Akhrass, Fady Al; Hachem, Ray; Raad, Issam

doi:10.1093/cid/cis1029

Cited by 55 publications

(46 citation statements)

References 40 publications

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“…The values of MR-proADM in this subgroup are similar to the global group. These results are similar to several studies in patients with hematological and solid cancer (57)(58)(59). In an extensive study of hematological patients, Al Shuaibi et al (57) demonstrated the value of initial MR-proADM levels of septic patients and nonseptic patients with SIRS; however, PCT levels were not useful in this sense.…”

Section: Marker Clearancesupporting

confidence: 85%

New role of biomarkers: mid-regional pro-adrenomedullin, the biomarker of organ failure

et al. 2016

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Mid-regional pro-adrenomedullin (MR-proADM) has a good biomarker profile: its half-life is several hours, and its plasma concentrations can be determined in clinical practice, it is essentially irrelevant, but proportionally represents the levels and activity of adrenomedullin (ADM). ADM synthesis is widely distributed in tissues, including bone, adrenal cortex, kidney, lung, blood vessels and heart. Its fundamental biological effects include vasodilator, positive inotropic, diuretic, natriuretic and bronchodilator. It has been described high levels in septic patients, interacting directly with the relaxation of vascular tone, triggering hypotension of these patients. It is also found high levels in other diseases such as hypertension, heart failure, respiratory failure, renal failure, cirrhosis and cancer. MR-proADM has been identified as a prognostic marker, stratifying the mortality risk in patients with sepsis in emergency department (ED) and ICU. Evolutionary MR-proADM levels and clearance marker to the 2nd-5th days of admission help to determine the poor performance and the risk of mortality in patients with severe sepsis admitted to the ICU. The MR-proADM levels are more effective than procalcitonin (PCT) and C-reactive protein (CRP) levels to determine an unfavorable outcome and the risk of mortality in patients with sepsis admitted to the ICU. It has also proved useful in patients diagnosed with organ dysfunction of infectious etiology. MR-proADM levels are independent of the germ conversely it is related to the magnitude of organ failure and therefore severity. We consider advisable incorporating the MR-proADM the panel of biomarkers necessary for the diagnosis and treatment of critically ill patients admitted to the ICU with severe sepsis. The combined PCT and MR-proADM levels could represent a valid tool in the clinical practice to timely identify patients with bacterial infections and guide the diagnosis and treatment of sepsis and septic shock.

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Section: Marker Clearancesupporting

confidence: 85%

New role of biomarkers: mid-regional pro-adrenomedullin, the biomarker of organ failure

et al. 2016

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“…PCT was a useful marker for diagnosing systemic or severe bacterial infections whereas it was hardly increased in local or mild systemic bacterial infection [17,18]. Pneumonia is recognized as severe LRTI closer to systemic infection whereas the symptoms of bronchitis are relatively milder.…”

Section: Discussionmentioning

confidence: 99%

The utility of biomarkers in differentiating bacterial from non-bacterial lower respiratory tract infection in hospitalized children: Difference of the diagnostic performance between acute pneumonia and bronchitis

Hoshina¹,

Nanishi²,

Kanno³

et al. 2014

Journal of Infection and Chemotherapy

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“…No independent associations were found between MR-proADM and newonset albuminuria. This is the first study evaluating the relationship between MR-proADM and mortality in patients with type 2 diabetes and the first to evaluate the relationship with newonset albuminuria (13,16,19,20,(24)(25)(26)31).…”

Section: Discussionmentioning

confidence: 99%

“…Increased plasma MR-proADM levels are also associated with the development of CV morbidity and have a role in predicting adverse outcomes in patients with coronary artery disease (14,16) and heart failure (15,17) and patients presenting to the emergency department with dyspnea (18). MR-proADM may also be useful for excluding the diagnosis of left ventricular failure (19), predicting the response to antimicrobials and estimating prognosis in patients with sepsis (20,21). Few studies exist with long-term follow-up (22).…”

mentioning

confidence: 99%

Midregional Fragment of Proadrenomedullin, New-Onset Albuminuria, and Cardiovascular and All-Cause Mortality in Patients With Type 2 Diabetes (ZODIAC-30)

et al. 2014

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OBJECTIVEThe midregional fragment of proadrenomedullin (MR-proADM) is a marker of endothelial dysfunction and has been associated with a variety of diseases. Our aim was to investigate whether MR-proADM is associated with new-onset albuminuria and cardiovascular (CV) and all-cause mortality in patients with type 2 diabetes treated in primary care. RESEARCH DESIGN AND METHODSPatients with type 2 diabetes participating in the observational Zwolle Outpatient Diabetes Project Integrating Available Care (ZODIAC) study were included. Cox regression analyses were used to assess the relation of baseline MR-proADM with new-onset albuminuria and CV and all-cause mortality. Risk prediction capabilities of MR-proADM for new-onset albuminuria and CV and all-cause mortality were assessed with Harrell's C and the integrated discrimination improvement. RESULTSIn 1,243 patients (mean age 67 [612] years), the median follow-up was 5.6 years (interquartile range 3.1-10.1); 388 (31%) patients died, with 168 (12%) CV deaths. Log 2 MR-proADM was associated with CV (hazard ratio 1.96 [95% CI 1.27-3.01]) and all-cause mortality (1.78 [1.34-2.36]) after adjusting for age, sex, BMI, smoking, systolic blood pressure, cholesterol-to-HDL ratio, duration of diabetes, HbA 1c , ACE inhibitor/angiotensin receptor blocker, history of CV diseases, log serum creatinine, and log albumin-to-creatinine ratio. MR-proADM slightly improved mortality risk prediction. The age-and sex-adjusted, but not multivariateadjusted, MR-proADM levels were associated with new-onset albuminuria. CONCLUSIONSMR-proADM was associated with CV and all-cause mortality in patients with type 2 diabetes after a median follow-up of 5.6 years. There was no independent relationship with new-onset albuminuria. In the availability of an extensive set of risk factors, there was little added effect of MR-proADM in risk prediction of CV and all-cause mortality.

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Pro-adrenomedullin as a Novel Biomarker for Predicting Infections and Response to Antimicrobials in Febrile Patients With Hematologic Malignancies

Abstract: ProADM and PCT have promising roles in assisting clinicians in managing febrile HM patients. However, proADM appears to have the advantage of predicting localized bacterial infection and differentiating sepsis from SIRS.

Cited by 55 publications

References 40 publications

New role of biomarkers: mid-regional pro-adrenomedullin, the biomarker of organ failure

New role of biomarkers: mid-regional pro-adrenomedullin, the biomarker of organ failure

The utility of biomarkers in differentiating bacterial from non-bacterial lower respiratory tract infection in hospitalized children: Difference of the diagnostic performance between acute pneumonia and bronchitis

Midregional Fragment of Proadrenomedullin, New-Onset Albuminuria, and Cardiovascular and All-Cause Mortality in Patients With Type 2 Diabetes (ZODIAC-30)

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