Prognostic potential of midregional pro‐adrenomedullin following decompensation for systolic heart failure: comparison with cardiac natriuretic peptides

Morbach, Caroline; Marx, Almuth; Kaspar, Mathias; Güder, Gülmisal; Brenner, Susanne; Feldmann, C.; Störk, Stefan; Vollert, J.; Ertl, Georg; Angermann, Christiane E.

doi:10.1002/ejhf.859

Cited by 33 publications

(38 citation statements)

References 42 publications

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“…The study on the prognostic utility of midregional pro‐adrenomedullin (MR‐proADM) following decompensation for systolic heart failure from the Interdisciplinary Network Heart Failure programme extends and corroborates insights gained from several previous studies on this emerging biomarker . While the exact pathophysiological triggers, the dominant tissue of its release into the circulation, and its clearance mechanisms are still incompletely understood, MR‐proADM concentrations have consistently been shown to be closely associated with the risk of death .…”

supporting

confidence: 69%

“…In most settings, the prognostic accuracy of MR‐proADM for all‐cause mortality was even higher compared with that provided by natriuretic peptides (NPs) . In contrast, MR‐proADM does not seem to provide incremental value in the prediction of rehospitalization or reverse remodelling …”

mentioning

confidence: 98%

“…While the exact pathophysiological triggers, the dominant tissue of its release into the circulation, and its clearance mechanisms are still incompletely understood, MR‐proADM concentrations have consistently been shown to be closely associated with the risk of death . In most settings, the prognostic accuracy of MR‐proADM for all‐cause mortality was even higher compared with that provided by natriuretic peptides (NPs) . In contrast, MR‐proADM does not seem to provide incremental value in the prediction of rehospitalization or reverse remodelling …”

mentioning

confidence: 99%

“…For this it would be necessary to know which therapies, for example, lower MR‐proADM concentrations. Unfortunately, in the current analysis neither the quality of baseline heart failure therapy (proportion of the guideline‐recommended target equivalence dose of each drug) nor the extent or direction of changes in drug doses during the study were associated with changes in MR‐proADM concentrations between hospital discharge and 6 month follow‐up . In contrast, at least a hint regarding interaction with therapy was recently observed for ST2 .…”

mentioning

confidence: 99%

“…In contrast, at least a hint regarding interaction with therapy was recently observed for ST2 . Fourth, reliable estimation of the risk of dying within the next months is clinically valuable as well . In clinical practice, the risk of death can be estimated using multivariable scores .…”

mentioning

confidence: 99%

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Clinical utility of biomarkers in heart failure

Müeller

2017

European J of Heart Fail

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supporting

confidence: 69%

mentioning

confidence: 98%

mentioning

confidence: 99%

mentioning

confidence: 99%

mentioning

confidence: 99%

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Clinical utility of biomarkers in heart failure

Müeller

2017

European J of Heart Fail

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Syncopes and clinical outcome in heart failure: results from prospective clinical study data in Germany

et al. 2020

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Aims Whereas syncopal episodes are a frequent complication of cardiovascular disorders, including heart failure (HF), little is known whether syncopes impact the prognosis of patients with HF. We aimed to assess the impact of a history of syncope (HoS) on overall and hospitalization-free survival of these patients. Methods and resultsWe pooled the data of prospective, nationwide, multicentre studies conducted within the framework of the German Competence Network for Heart Failure including 11 335 subjects. Excluding studies with follow-up periods <10 years, we assessed 5318 subjects. We excluded a study focusing on cardiac changes in patients with an HIV infection because of possible confounding factors and 849 patients due to either missing key parameters or missing follow-up data, resulting in 3594 eligible subjects, including 2130 patients with HF [1564 patients with heart failure with reduced ejection fraction (HFrEF), 314 patients with heart failure with mid-range ejection fraction, and 252 patients with heart failure with preserved ejection fraction (HFpEF)] and 1464 subjects without HF considered as controls. HoS was more frequent in the overall cohort of patients with HF compared with controls (P < 0.001)-mainly driven by the HFpEF subgroup (HFpEF vs. controls: 25.0% vs. 12.8%, P < 0.001). Of all the subjects, 14.6% reported a HoS. Patients with HFrEF in our pooled cohort showed more often syncopes than subjects without HF (15.0% vs. 12.8%, P = 0.082). Subjects with HoS showed worse overall survival [42.4% vs. 37.9%, hazard ratio (HR) = 1.21, 99% confidence interval (0.99, 1.46), P = 0.04] and less days alive out of hospital [HR = 1.39, 99% confidence interval (1.18, 1.64), P < 0.001] compared with all subjects without HoS. Patients with HFrEF with HoS died earlier [30.3% vs. 41.6%, HR = 1.40, 99% confidence interval (1.12, 1.74), P < 0.001] and lived fewer days out of hospital than those without HoS. We could not find these changes in mortality and hospital-free survival in the heart failure with mid-range ejection fraction and HFpEF cohorts. HoS represented a clinically high-risk profile within the HFrEF group-combining different risk factors. Further analyses showed that among patients with HFrEF with HoS, known cardiovascular risk factors (e.g. age, male sex, diabetes mellitus, and anaemia) were more prevalent. These constellations of the risk factors explained the effect of HoS in a multivariable Cox regression models. Conclusions In a large cohort of patients with HF, HoS was found to be a clinically and easily accessible predictor of both overall and hospitalization-free survival in patients with HFrEF and should thus routinely be assessed.

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Biomarkers in the management of acute heart failure: state of the art and role in COVID‐19 era

et al. 2021

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Acute heart failure (AHF) affects millions of people worldwide, and it is a potentially life‐threatening condition for which the cardiologist is more often brought into play. It is crucial to rapidly identify, among patients presenting with dyspnoea, those with AHF and to accurately stratify their risk, in order to define the appropriate setting of care, especially nowadays due to the coronavirus disease 2019 (COVID‐19) outbreak. Furthermore, with physical examination being limited by personal protective equipment, the use of new alternative diagnostic and prognostic tools could be of extreme importance. In this regard, usage of biomarkers, especially when combined (a multimarker approach) is beneficial for establishment of an accurate diagnosis, risk stratification and post‐discharge monitoring. This review highlights the use of both traditional biomarkers such as natriuretic peptides (NP) and troponin, and emerging biomarkers such as soluble suppression of tumourigenicity (sST2) and galectin‐3 (Gal‐3), from patients' emergency admission to discharge and follow‐up, to improve risk stratification and outcomes in terms of mortality and rehospitalization.

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Prognostic potential of midregional pro‐adrenomedullin following decompensation for systolic heart failure: comparison with cardiac natriuretic peptides

Abstract: MR-proADM was found to correlate with the global disease burden in HF and proved a potent prognostic indicator, capturing the risk for both cardiac and non-cardiac death. Serial MR-proADM measurements further enhanced risk assessment, thus facilitating substantial reclassification.

Cited by 33 publications

References 42 publications

Clinical utility of biomarkers in heart failure

Clinical utility of biomarkers in heart failure

Syncopes and clinical outcome in heart failure: results from prospective clinical study data in Germany

Biomarkers in the management of acute heart failure: state of the art and role in COVID‐19 era

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