Mid-region pro-adrenomedullin adds predictive value to clinical predictors and Framingham risk score for long-term mortality in stable outpatients with heart failure.

Abstract

AIMS:

The aim of this study was to evaluate the long-term prognostic utility of mid-region prohormone adrenomedullin (MR-proADM) in stable outpatients with heart failure (HF).

METHODS AND RESULTS:

Echocardiogram and serum for MR-proADM and BNP levels were obtained in 724 stable outpatients. These patients were followed for up to 6 years for the primary endpoint of all-cause mortality. There were 198 stage A patients, 328 stage B patients, and 200 stage C/D patients, with an average age of 68 ± 12 years. There were 195 deaths during the 6-year follow-up period. MR-proADM was predictive of mortality in the overall patient population. The predictive value of MR-proADM for long-term mortality was independent of BNP, echocardiographic indices of structural heart disease, clinical predictors of mortality, and the Framingham risk score. Patients with elevated MR-proADM had significantly increased risk for mortality in stage A and stage C/D HF, with hazard ratio (HR) 3.780, P < 0.001 and HR 2.744, P < 0.001, respectively. There was a trend toward increased mortality in patients with elevated MR-proADM and stage B HF (HR 1.579, P = 0.05005). MR-proADM added incremental predictive value to clinical predictors and the Framingham risk score.

CONCLUSIONS:

MR-proADM was a potent independent predictor of long-term all-cause mortality in stable outpatients with stage A-D HF, especially in patients in stage A and stage C/D HF. MR-proADM added incremental predictive value to clinical predictors and the Framingham risk score.

• Authors: Yang Xue, Pam Taub, Navaid Iqbal, Arrash Fard, Paul Clopton, Alan Maisel
• Journal: European journal of heart failure (Eur J Heart Fail) Vol. 15 Issue 12 Pg. 1343-9 (Dec 2013) ISSN: 1879-0844 [Electronic] England
• PMID: 23887059 (Publication Type: Journal Article, Research Support, Non-U.S. Gov't)

Chemical References

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

Topics

• Adrenomedullin (blood)
• Aged
• Biomarkers (blood)
• Echocardiography
• Female
• Heart Failure (blood, diagnosis, mortality, physiopathology)
• Humans
• Kaplan-Meier Estimate
• Male
• Middle Aged
• Mortality
• Natriuretic Peptide, Brain (blood)
• Patient Acuity
• Peptide Fragments (blood)
• Predictive Value of Tests
• Prognosis
• Protein Precursors (blood)
• Risk Assessment
• United States (epidemiology)