Thirty and ninety days mortality predictive value of admission and in-hospital procalcitonin and mid-regional pro-adrenomedullin testing in patients with dyspnea. Results from the VERyfing DYspnea trial

Travaglino, Francesco; Russo, Veronica; Berardinis, Benedetta De; Numeroso, Filippo; Catania, Pamela; Cervellin, Gianfranco; Nigra, Stefano Geniere; Geraci, Francesco; Bressan, Maria Antonietta; Guerrini, Stefania; Cavazza, Mario; Folli, Christian; Monzani, Valter; Battista, Stefania; Mengozzi, Giulio; Noto, Paola; Carpinteri, Giuseppe; Semplicini, Andrea; Stella, Federica; Ingrassia, Stella; Moscatelli, P; Giuntini, Patrizia; Salerno, Gerardo; Cardelli, Patrizia; Somma, Salvatore Di

doi:10.1016/j.ajem.2013.12.045

Cited by 33 publications

(22 citation statements)

References 38 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…ADM is elevated in cardiac failure proportionally to the severity of the disease assessed by NYHA class and to the degree of left ventricular impairment (9,12). 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.…”

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

View full text Add to dashboard Cite

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.

show abstract

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

View full text Add to dashboard Cite

show abstract

“…PCT has become a well-known biomarker that may help physicians working in the emergency department (ED) to identify sepsis promptly and guide antibiotic administration. 36 Travaglino et al 37 demonstrated that PCT may be useful for assisting ED physicians, in terms of detecting infectious disease during early risk stratification in those presenting with acute dyspnoea (with an AUC of 0.65 and a cut-off of 0.09 ng/ml). Wang and colleagues found that the serum PCT level, and not the CRP level, could be used as a negative predictor for excluding bloodstream infections, with a best cut-off value of 0.80 ng/ml (83% sensitivity; 65% specificity) in critically ill patients.…”

Section: Discussionmentioning

confidence: 99%

Measuring both procalcitonin and C-reactive protein for a diagnosis of sepsis in critically ill patients

et al. 2014

View full text Add to dashboard Cite

Background: The usefulness of procalcitonin (PCT) and C-reactive protein (CRP) as individual biomarkers, and in combination, for the identification of infections in a critically ill patient cohort was evaluated retrospectively. Methods: Best cut-off values for PCT and CRP for a diagnosis of sepsis in critically ill patients were determined using receiver operator characteristic (ROC) curve analysis. Both combined tests and individual tests were performed for PCT and CRP, with positive and negative results recorded, and accuracy evaluated using odds ratios (OR). Results: In the 55 critically ill patients studied, the best cut-off value for PCT for a diagnosis of sepsis was 1.1 ng/ml (sensitivity, specificity and negative predictive values [NPV] were 82%, 68% and 71%, respectively). In addition, the best cut-off value for CRP was 50.7 mg/l ( sensitivity, specificity and NPV of 90%, 68% and 83%, respectively). Measuring PCT and CRP in combination provided a sensitivity of 79%, a specificity of 86%, and a positive predictive value (PPV) of 90%. Diagnostic OR for the combination of biomarkers versus CRP alone (19 and 18, respectively) were greater than that for PCT (9). Conclusion: For critically ill patients, CRP and CRP in combination with PCT were found to be suitable biomarkers for diagnosing sepsis, based on their NPV and PPV.

show abstract

“…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%

“…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%

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)

View full text Add to dashboard Cite

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.

show abstract

Thirty and ninety days mortality predictive value of admission and in-hospital procalcitonin and mid-regional pro-adrenomedullin testing in patients with dyspnea. Results from the VERyfing DYspnea trial

Cited by 33 publications

References 38 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

Measuring both procalcitonin and C-reactive protein for a diagnosis of sepsis in critically ill patients

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

Contact Info

Product

Resources

About