MR-proANP and MR-proADM for risk stratification of patients with acute chest pain
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MR-proANP and MR-proADM for risk stratification of patients with acute chest pain. / Tzikas, Stergios; Keller, Till; Ojeda, Francisco M; Zeller, Tanja; Wild, Philipp S; Lubos, Edith; Kunde, Jan; Baldus, Stephan; Bickel, Christoph; Lackner, Karl J; Münzel, Thomas F; Blankenberg, Stefan.
in: HEART, Jahrgang 99, Nr. 6, 03.2013, S. 388-95.Publikationen: SCORING: Beitrag in Fachzeitschrift/Zeitung › SCORING: Zeitschriftenaufsatz › Forschung › Begutachtung
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TY - JOUR
T1 - MR-proANP and MR-proADM for risk stratification of patients with acute chest pain
AU - Tzikas, Stergios
AU - Keller, Till
AU - Ojeda, Francisco M
AU - Zeller, Tanja
AU - Wild, Philipp S
AU - Lubos, Edith
AU - Kunde, Jan
AU - Baldus, Stephan
AU - Bickel, Christoph
AU - Lackner, Karl J
AU - Münzel, Thomas F
AU - Blankenberg, Stefan
PY - 2013/3
Y1 - 2013/3
N2 - OBJECTIVE: To evaluate mid-regional pro-adrenomedullin (MR-proADM) and mid-regional pro-atrial natriuretic peptide (MR-proANP) as prognostic biomarkers in a representative 'real world' cohort of patients with suspected acute coronary syndrome (ACS).DESIGN: Prospective observational multicentre cohort study.SETTING: Chest pain units of three major hospitals in Germany from 2007 to 2008.PATIENTS: Patients presenting with signs and symptoms suggestive of an ACS.MAIN OUTCOME MEASURES: Primary end point was death or non-fatal myocardial infarction (MI), and secondary end point was death, non-fatal MI, stroke, need for coronary revascularisation, and hospital admission for cardiovascular cause or acute heart failure within 6 months after enrolment.RESULTS: 1386 patients (male/female = 920/466) were enrolled. Follow-up information was available for 97.8% of patients (median follow-up time 183 days). Forty-three patients reached the primary end point, and 132 the secondary end point. Patients who reached a primary end point had significantly higher MR-proANP (271 vs 101 pmol/l, p < 0.001) and MR-proADM (0.86 vs 0.59 nmol/l, p < 0.001) concentrations than those who did not. Cox regression analysis revealed a 2.55-fold risk of death or non fatal MI (95% CI 1.48 to 2.46, p < 0.001) for an increment of the log-transformed MR-proANP concentration by 1 SD after adjustment for cardiovascular risk factors, and a 1.91-fold risk (95% CI 1.48 to 2.46, p < 0.001) for MR-proADM. Both peptides could result in significant reclassification of patients when added to the Global Registry of Acute Coronary Events risk score, with an overall net reclassification improvement of 41.2% for MR-proADM and 35.7% for MR-proANP.CONCLUSIONS: MR-proADM and MR-proANP are predictors of future cardiovascular events in patients presenting with acute chest pain and might facilitate the choice of treatment in those patients complementary to established risk scores.
AB - OBJECTIVE: To evaluate mid-regional pro-adrenomedullin (MR-proADM) and mid-regional pro-atrial natriuretic peptide (MR-proANP) as prognostic biomarkers in a representative 'real world' cohort of patients with suspected acute coronary syndrome (ACS).DESIGN: Prospective observational multicentre cohort study.SETTING: Chest pain units of three major hospitals in Germany from 2007 to 2008.PATIENTS: Patients presenting with signs and symptoms suggestive of an ACS.MAIN OUTCOME MEASURES: Primary end point was death or non-fatal myocardial infarction (MI), and secondary end point was death, non-fatal MI, stroke, need for coronary revascularisation, and hospital admission for cardiovascular cause or acute heart failure within 6 months after enrolment.RESULTS: 1386 patients (male/female = 920/466) were enrolled. Follow-up information was available for 97.8% of patients (median follow-up time 183 days). Forty-three patients reached the primary end point, and 132 the secondary end point. Patients who reached a primary end point had significantly higher MR-proANP (271 vs 101 pmol/l, p < 0.001) and MR-proADM (0.86 vs 0.59 nmol/l, p < 0.001) concentrations than those who did not. Cox regression analysis revealed a 2.55-fold risk of death or non fatal MI (95% CI 1.48 to 2.46, p < 0.001) for an increment of the log-transformed MR-proANP concentration by 1 SD after adjustment for cardiovascular risk factors, and a 1.91-fold risk (95% CI 1.48 to 2.46, p < 0.001) for MR-proADM. Both peptides could result in significant reclassification of patients when added to the Global Registry of Acute Coronary Events risk score, with an overall net reclassification improvement of 41.2% for MR-proADM and 35.7% for MR-proANP.CONCLUSIONS: MR-proADM and MR-proANP are predictors of future cardiovascular events in patients presenting with acute chest pain and might facilitate the choice of treatment in those patients complementary to established risk scores.
KW - Acute Disease
KW - Adrenomedullin/blood
KW - Atrial Natriuretic Factor/blood
KW - Biomarkers/blood
KW - Chest Pain/blood
KW - Follow-Up Studies
KW - Germany/epidemiology
KW - Humans
KW - Incidence
KW - Myocardial Infarction/complications
KW - Peptide Fragments/blood
KW - Prognosis
KW - Prospective Studies
KW - Protein Precursors/blood
KW - Risk Assessment
KW - Survival Rate/trends
U2 - 10.1136/heartjnl-2012-302956
DO - 10.1136/heartjnl-2012-302956
M3 - SCORING: Journal article
C2 - 23213173
VL - 99
SP - 388
EP - 395
JO - HEART
JF - HEART
SN - 1355-6037
IS - 6
ER -
