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

Yuyun, Matthew F.; Narayan, Hafid; Ng, Leong L.

doi:10.1016/j.amjcard.2015.01.027

Cited by 41 publications

(33 citation statements)

References 41 publications

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“…Even though triage scores are developed to predict high initial treatment priority, daily decisions have to take into account harmful adverse events to further improve early risk stratification. As biomarker, ProADM was shown to provide relevant prognostic information in regard to the risk for adverse events within several prior studies focusing on selected patient subgroups with CAP [32–34], chronic obstructive pulmonary disease (COPD) [15, 35], or cardiovascular diseases [36, 37]. Our study now expands these findings and shows the prognostic value of ProADM for the first time in an unselected patient population.…”

Section: Discussionsupporting

confidence: 73%

The TRIAGE-ProADM Score for an Early Risk Stratification of Medical Patients in the Emergency Department - Development Based on a Multi-National, Prospective, Observational Study

et al. 2016

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IntroductionThe inflammatory biomarker pro-adrenomedullin (ProADM) provides additional prognostic information for the risk stratification of general medical emergency department (ED) patients. The aim of this analysis was to develop a triage algorithm for improved prognostication and later use in an interventional trial.MethodsWe used data from the multi-national, prospective, observational TRIAGE trial including consecutive medical ED patients from Switzerland, France and the United States. We investigated triage effects when adding ProADM at two established cut-offs to a five-level ED triage score with respect to adverse clinical outcome.ResultsMortality in the 6586 ED patients showed a step-wise, 25-fold increase from 0.6% to 4.5% and 15.4%, respectively, at the two ProADM cut-offs (≤0.75nmol/L, >0.75–1.5nmol/L, >1.5nmol/L, p ANOVA <0.0001). Risk stratification by combining ProADM within cut-off groups and the triage score resulted in the identification of 1662 patients (25.2% of the population) at a very low risk of mortality (0.3%, n = 5) and 425 patients (6.5% of the population) at very high risk of mortality (19.3%, n = 82). Risk estimation by using ProADM and the triage score from a logistic regression model allowed for a more accurate risk estimation in the whole population with a classification of 3255 patients (49.4% of the population) in the low risk group (0.3% mortality, n = 9) and 1673 (25.4% of the population) in the high-risk group (15.1% mortality, n = 252).ConclusionsWithin this large international multicenter study, a combined triage score based on ProADM and established triage scores allowed a more accurate mortality risk discrimination. The TRIAGE-ProADM score improved identification of both patients at the highest risk of mortality who may benefit from early therapeutic interventions (rule in), and low risk patients where deferred treatment without negatively affecting outcome may be possible (rule out).

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Section: Discussionsupporting

confidence: 73%

The TRIAGE-ProADM Score for an Early Risk Stratification of Medical Patients in the Emergency Department - Development Based on a Multi-National, Prospective, Observational Study

et al. 2016

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“…Besides, the expression of ADM2 and ADM are also increased in leukocytes of patients with chronic heart failure (Cabiati et al , ), suggesting that both ADM and ADM2 may act as a plasma biomarker for heart failure. ADM has been shown to be an independent predictor of death for heart failure (Yuyun et al , ). The plasma level of ADM2 is also increased in patients with heart failure (Bell et al , ).…”

Section: Adm2 and Cardiometabolic Diseasesmentioning

confidence: 99%

Adrenomedullin 2/intermedin: a putative drug candidate for treatment of cardiometabolic diseases

Zhang

Wang

2017

British J Pharmacology

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Adrenomedullin (ADM) 2/intermedin (IMD) is a short peptide that belongs to the CGRP superfamily. Although it shares receptors with CGRP, ADM and amylin, ADM2 has significant and unique functions in the cardiovascular system. In the past decade, the cardiovascular effect of ADM2 has been carefully analysed. In this review, progress in understanding the effects of ADM2 on the cardiovascular system and its protective role in cardiometabolic diseases are summarized. LINKED ARTICLESThis article is part of a themed section on Spotlight on Small Molecules in Cardiovascular Diseases. To view the other articles in this section visit http://onlinelibrary.wiley.com/doi/10.1111/bph.v175.8/issuetoc Abbreviations AAC, abdominal aortic constriction; ACS, acute coronary syndrome; ADM, adrenomedullin; AMPK, AMP-activated protein kinase; AMY, amylin; CRLR, calcitonin receptor-like receptor; ER, endoplasmic reticulum; I/R, ischaemia/reperfusion; RAMP, receptor activity-modifying protein; SHR, spontaneously hypertensive rat; TAC, transverse aortic contraction; VSMC, vascular smooth muscle cell Takei et al., 2004). It is one of the members of the ADM family which are all found in fish but, in mammals, only three peptides -ADM, ADM2 and ADM5 -have been found (Takei et al., 2008). These ADM peptides are themselves a part of the CGRP superfamily. ADM2 is also called intermedin (IMD), owing to its high expression in the intermediate lobe of the pituitary. Both terms, 'ADM2' and 'IMD', are widely used in the literature. However, because IMD was used as the former name for α-melanocyte stimulating hormone, we will use the terms ADM2, ADM2/IMD 1-53 , ADM2/IMD 1-47 and ADM2/IMD 1-40 in this review to avoid confusion. ADM2 shares receptors with CGRP, ADM and amylin (AMY) (Hay et al., 2005) and is widely expressed throughout the body. Recently, progress has been made on the physiological roles of ADM2 in cardiovascular homeostasis and as a protective agent against cardiometabolic diseases. In this review, the structure and expression of ADM2 and the pharmacology of ADM2, in the context of the cardiovascular system and cardiometabolic diseases, are summarized. ADM2 and ADM2 receptorsThe structure of ADM2The Adm2 gene is located on the distal arm of human chromosome 22q13.33 and encodes a pre-pro-peptide containing 148 amino acid residues with a signal sequence at the N terminus . ADM2 belongs to the CGRP superfamily, which includes α-CGRP, β-CGRP, calcitonin receptor-stimulating peptide, AMY, ADM and ADM5 (Hong et al., 2012). ADM2 shares the same structural characteristics with the other family members, including an intramolecular ring of six amino acids residues flanked by a disulfide bond and a putative amidation signal at the C terminus .Sequence alignment has shown that ADM2 shares only 28% sequence identity with its closest paralogue, ADM.However, ADM2 is highly conserved in the orthologues of different species. The mature human ADM2 shares over 60% similarity with fish and 87% identity with the rodent peptides . The property of high con...

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“…Adrenomedullin is ubiquitously prevalent in cardiac, vascular, renal, pulmonary, and endocrine tissues, and has diuretic, natriuretic, vasodilatory, hypotensive, and angiogenic properties . Its short plasma half‐life limits diagnostic applicability, but an assay measuring midregional pro‐adrenomedullin (MR‐proADM), a bio‐inactive more stable pro‐hormone fragment, is available …”

Section: Introductionmentioning

confidence: 99%

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

Morbach

Marx

Kaspar

et al. 2017

European J of Heart Fail

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

Cited by 41 publications

References 41 publications

The TRIAGE-ProADM Score for an Early Risk Stratification of Medical Patients in the Emergency Department - Development Based on a Multi-National, Prospective, Observational Study

The TRIAGE-ProADM Score for an Early Risk Stratification of Medical Patients in the Emergency Department - Development Based on a Multi-National, Prospective, Observational Study

Adrenomedullin 2/intermedin: a putative drug candidate for treatment of cardiometabolic diseases

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

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