Circulating chromogranin B levels in patients with acute respiratory failure: data from the FINNALI Study.

Abstract

PURPOSE:

Circulating chromogranin B (CgB) levels are increased in situations characterized by systemic and myocardial stress, but whether CgB provides prognostic information in patients with acute respiratory failure (ARF) is unknown.

METHODS:

We included 584 patients with ARF, defined as ventilatory support >6 h, and with blood samples available on Intensive Care Unit (ICU) admission and day 3 (n = 479). CgB levels were measured by radioimmunoassay and follow-up was 90 days.

RESULTS:

One-hundred-sixty-nine patients (29%) died during follow-up. Admission CgB levels separated non-survivors from survivors: median 1234 (Q1-3 989-1742) vs. 917 (753-1224) pmol/L, respectively, p < 0.001. CgB levels on ICU admission (logarithmically transformed) were associated with time to death after adjustment for established risk indices available on ICU admission, including N-terminal pro-B-type natriuretic levels: HR 2.62 (95%C.I. 1.82-3.77), p < 0.001. Admission CgB levels also improved prognostication on top of SOFA and SAPS II scores as assessed by Cox regression analyses and the category-free net reclassification index. The area under the curve (AUC) for admission CgB levels to separate survivors and non-survivors was 0.72 (95%CI 0.67-0.76), while the AUC on day 3 was 0.60 (0.54-0.66).

CONCLUSIONS:

CgB levels measured on ICU admission provided additional prognostic information to established risk indices in ARF patients.

• Authors: Peder Langeland Myhre, Mats Stridsberg, Rita Linko, Marjatta Okkonen, Ståle Nygård, Geir Christensen, Ville Pettilä, Torbjørn Omland, Helge Røsjø, FINNALI Study Group
• Journal: Biomarkers : biochemical indicators of exposure, response, and susceptibility to chemicals (Biomarkers) Vol. 22 Issue 8 Pg. 775-781 (Dec 2017) ISSN: 1366-5804 [Electronic] England
• PMID: 28049363 (Publication Type: Journal Article)

Chemical References

• Biomarkers
• Chromogranin B
• Natriuretic Peptide, Brain

Topics

• Acute Disease
• Aged
• Biomarkers (blood)
• Chromogranin B (blood)
• Female
• Follow-Up Studies
• Humans
• Intensive Care Units (statistics & numerical data)
• Male
• Middle Aged
• Natriuretic Peptide, Brain (blood)
• Prognosis
• Proportional Hazards Models
• Respiratory Insufficiency (blood, diagnosis, mortality)
• Survival Rate