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Midregional proadrenomedullin for prediction of cardiovascular events in coronary artery disease: results from the AtheroGene study.

AbstractBACKGROUND:
Midregional proadrenomedullin (MR-proADM) is a newly identified prognostic marker in heart failure. We evaluated the prognostic impact of MR-proADM in a cohort of patients with symptomatic coronary artery disease according to their clinical presentation.
METHODS:
We measured baseline MR-proADM concentrations in 2240 individuals from the prospective AtheroGene study and evaluated the prognostic impact on future fatal and nonfatal cardiovascular events during a follow-up period of 3.6 (1.6) years.
RESULTS:
The sample comprised 1355 individuals with stable angina pectoris (SAP) and 885 with acute coronary syndrome (ACS). A cardiovascular event occurred in 192 people. Individuals presenting with SAP had only slightly lower plasma MR-proADM concentrations than those with ACS (0.53 vs 0.55 nmol/L, P=0.006). MR-proADM showed a moderate association with age, serum N-terminal pro-B-type natriuretic peptide (NT-proBNP), glomerular filtration rate, serum C-reactive protein, hypertension, diabetes, and prevalent multivessel disease (all P<0.0005). Individuals suffering from a cardiovascular event had higher MR-proADM concentrations at baseline in both groups (SAP 0.63 vs 0.53 nmol/L and ACS 0.65 nmol/L vs 0.55 nmol/L, both P<0.0005). Cox regression analysis incorporating various variables of cardiovascular risk and NT-proBNP revealed a hazard ratio of 1.4 (95% CI 1.2-1.6; P<0.0005) per increment of MR-proADM by 1SD. In risk models for secondary prevention, MR-proADM provided information comparable to that of NT-proBNP.
CONCLUSIONS:
MR-proADM is an independent predictor for future cardiovascular events in patients with symptomatic coronary artery disease, providing information comparable to NT-proBNP for secondary risk stratification.
AuthorsPhilipp S Wild, Renate B Schnabel, Edith Lubos, Tanja Zeller, Christoph R Sinning, Till Keller, Stergios Tzikas, Karl J Lackner, Dirk Peetz, Hans J Rupprecht, Christoph Bickel, Nils G Morgenthaler, Jana Papassotiriou, Laurence Tiret, Thomas Münzel, Stefan Blankenberg
JournalClinical chemistry (Clin Chem) Vol. 58 Issue 1 Pg. 226-36 (Jan 2012) ISSN: 1530-8561 [Electronic] England
PMID22065157 (Publication Type: Journal Article)
Chemical References
  • Biomarkers
  • Peptide Fragments
  • Protein Precursors
  • pro-brain natriuretic peptide (1-76)
  • proadrenomedullin
  • Natriuretic Peptide, Brain
  • Adrenomedullin
Topics
  • Acute Coronary Syndrome (diagnosis, mortality, physiopathology)
  • Adrenomedullin (blood)
  • Aged
  • Angina Pectoris (diagnosis, mortality, physiopathology)
  • Biomarkers (blood)
  • Coronary Artery Disease (diagnosis, mortality, physiopathology)
  • Female
  • Humans
  • Immunoassay
  • Kaplan-Meier Estimate
  • Luminescent Measurements
  • Male
  • Middle Aged
  • Natriuretic Peptide, Brain (blood)
  • Peptide Fragments (blood)
  • Predictive Value of Tests
  • Prognosis
  • Prospective Studies
  • Protein Precursors (blood)
  • Risk Assessment

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