Serum concentration of chromogranin A at admission: an early biomarker of severity in critically ill patients.

Abstract

BACKGROUND:

Chromogranin A (CGA), a stress marker released with catecholamines by the adrenal medulla, has never been associated with acute inflammation in critically ill patients.

AIM:

To determine evidence for a link between serum concentration of CGA, biomarkers of inflammation, and outcome inpatients admitted with or without the systemic inflammatory response syndrome (SIRS).

METHODS:

At admission, we measured in 53 patients and 14 healthy controls the serum concentrations of CGA,procalcitonin, and C-reactive protein. We also assessed the Simplified Acute Physiological Score (SAPS) in the patients.

RESULTS:

Serum CGA concentrations were significantly increased in SIRS patients with a median value of 115 microg/L (68.0-202.8), when compared to healthy controls (PB0.001). In cases where infection was associated with SIRS, patients had the highest increase in CGA with a median value of 138.5 microg/L (65-222.3) (PB0.001). CGA concentrations positively correlated with inflammation markers (procalcitonin, C-reactive protein), but also with SAPS. Receiver operating characteristic (ROC) analysis showed that CGA is equivalent to SAPS as an indicator for 28-day mortality (area under curve (AUC) for both: 0.810).

CONCLUSIONS:

Patients with CGA concentration superior to 71 microg/L have a significantly shorter survival. A Cox model confirmed that CGA and SAPS were independent predictors of outcome.

• Authors: Dan Zhang, Thomas Lavaux, Rémy Sapin, Thierry Lavigne, Vincent Castelain, Dominique Aunis, Marie-Hélène Metz-Boutigue, Francis Schneider
• Journal: Annals of medicine (Ann Med) Vol. 41 Issue 1 Pg. 38-44 ( 2009) ISSN: 1365-2060 [Electronic] England
• PMID: 18720287 (Publication Type: Journal Article, Research Support, Non-U.S. Gov't)

Chemical References

• Biomarkers
• CALCA protein, human
• Chromogranin A
• Protein Precursors
• Calcitonin
• C-Reactive Protein
• Calcitonin Gene-Related Peptide

Topics

• Adult
• Aged
• Biomarkers (blood)
• C-Reactive Protein (metabolism)
• Calcitonin (blood)
• Calcitonin Gene-Related Peptide
• Chromogranin A (blood)
• Critical Illness
• Female
• Humans
• Intensive Care Units
• Male
• Middle Aged
• Patient Admission
• Prognosis
• Prospective Studies
• Protein Precursors (blood)
• ROC Curve
• Severity of Illness Index
• Survival Rate
• Systemic Inflammatory Response Syndrome (diagnosis, mortality)