Association of midregional proadrenomedullin with coronary artery stenoses, soft atherosclerotic plaques and coronary artery calcium.

Abstract

Midregional proadrenomedullin (MR-proADM) is elevated in patients with heart failure and myocardial infarction. The aim of this study was to evaluate the association of MR-proADM with the grade of coronary artery stenosis, presence of coronary artery soft plaques and coronary artery calcification score (CACS), determined by 64-multislice computed tomography (MSCT) in patients without known prior cardiovascular disease. This retrospective study included 107 patients undergoing MSCT for confirmation (or exclusion) of coronary artery disease. MR-proADM levels were measured in all patients. The assessment of coronary artery stenoses, CACS and soft coronary plaques was made by MSCT using known criteria. The MR-proADM [median (25th-75th percentiles)] level was 0.33 (0.21-0.43) nmol/l. The MR-proADM level was 0.28 (0.22-0.40) nmol/l in patients with coronary stenoses ≥50% (n = 23) versus 0.33 (0.27-0.40) nmol/l in patients with coronary stenoses <50% (n = 83, P = 0.59), 0.33 (0.26-0.40) nmol/l in patients with soft plaques (n = 56) versus 0.33 (0.25-0.41) nmol/l in patients without soft plaques (n = 50, P = 0.73) and 0.33 (0.25-0.39) nmol/l in patients with CACS <200 (n = 81) versus 0.32 (0.26-0.44) nmol/l in patients with CACS ≥200 (n = 26, P = 0.77). In multivariate analysis, the MR-proADM level was a significant correlate of coronary artery stenoses [odds ratio (OR) = 0.93; 95% confidence interval (CI) 0.86-0.99; P = 0.026] and soft plaques (OR = 0.94; 95% CI 0.90-0.99; P = 0.015) but not of CACS (OR = 0.98; 95% CI 0.93-1.03; P = 0.36). A decreased MR-proADM level is an independent correlate of the presence of coronary artery disease and of soft atherosclerotic plaques. Patients with decreased MR-proADM levels may need invasive examinations to diagnose more severe forms of coronary artery disease.

• Authors: Marcel Roos, Tibor Schuster, Gjin Ndrepepa, Marcus Baumann, Jens Lutz, Siegmund Braun, Stefan Martinof, Albert Schömig, Uwe Heemann, Adnan Kastrati, Jörg Hausleiter
• Journal: Heart and vessels (Heart Vessels) Vol. 27 Issue 4 Pg. 352-9 (Jul 2012) ISSN: 1615-2573 [Electronic] Japan
• PMID: 21725669 (Publication Type: Journal Article)

Chemical References

• Biomarkers
• Peptide Fragments
• Protein Precursors
• mid-regional pro-adrenomedullin, human
• Adrenomedullin

Topics

• Adrenomedullin (blood)
• Adult
• Aged
• Aged, 80 and over
• Biomarkers (blood)
• Chi-Square Distribution
• Coronary Angiography (methods)
• Coronary Artery Disease (blood, diagnosis, diagnostic imaging, pathology)
• Coronary Stenosis (blood, diagnosis, diagnostic imaging, pathology)
• Coronary Vessels (chemistry, pathology)
• Down-Regulation
• Female
• Germany
• Humans
• Logistic Models
• Male
• Middle Aged
• Multidetector Computed Tomography
• Multivariate Analysis
• Odds Ratio
• Peptide Fragments (blood)
• Plaque, Atherosclerotic
• Predictive Value of Tests
• Prognosis
• Protein Precursors (blood)
• ROC Curve
• Retrospective Studies
• Risk Assessment
• Risk Factors
• Severity of Illness Index
• Vascular Calcification (blood, diagnosis, diagnostic imaging, pathology)