Bioactive adrenomedullin, proenkephalin A and clinical outcomes in an acute heart failure setting.
acute heart failure
bioactive adrenomedullin
congestion
proenkephalin
worsening renal function
Journal
Open heart
ISSN: 2053-3624
Titre abrégé: Open Heart
Pays: England
ID NLM: 101631219
Informations de publication
Date de publication:
Historique:
received:
11
03
2019
revised:
20
05
2019
accepted:
13
06
2019
entrez:
30
7
2019
pubmed:
30
7
2019
medline:
30
7
2019
Statut:
epublish
Résumé
In an acute heart failure (AHF) setting, proenkephalin A 119-159 (penKid) has emerged as a promising prognostic marker for predicting worsening renal function (WRF), while bioactive adrenomedullin (bio-ADM) has been proposed as a potential marker for congestion. We examined the diagnostic value of bio-ADM in congestion and penKid in WRF and investigated the prognostic value of bio-ADM and penKid regarding mortality, rehospitalisation and length of hospital stay in two separate European AHF cohorts. Bio-ADM and penKid were measured in 530 subjects hospitalised for AHF in two cohorts: Swedish HeArt and bRain failure inVESTigation trial (HARVEST-Malmö) (n=322, 30.1% female; mean age 75.1+11.1 years; 12 months follow-up) and Italian GREAT Network Rome study (n=208, 54.8% female; mean age 78.5+9.9 years; no follow-up available). PenKid was associated with WRF (area under the curve (AUC) 0.65, p<0.001). In multivariable logistic regression analysis of the pooled cohort, penKid showed an independent association with WRF (adjusted OR (aOR) 1.74, p=0.004). Bio-ADM was associated with peripheral oedema (AUC 0.71, p<0.001), which proved to be independent after adjustment (aOR 2.30, p<0.001). PenKid was predictive of in-hospital mortality (OR 2.24, p<0.001). In HARVEST-Malmö, both penKid and bio-ADM were predictive of 1-year mortality (aOR 1.34, p=0.038 and aOR 1.39, p=0.030). Furthermore, bio-ADM was associated with rehospitalisation (aOR 1.25, p=0.007) and length of hospital stay (β=0.702, p=0.005). In two different European AHF cohorts, bio-ADM and penKid perform as suitable biomarkers for early detection of congestion severity and WRF occurrence, respectively, and are associated with pertinent clinical outcomes.
Identifiants
pubmed: 31354956
doi: 10.1136/openhrt-2019-001048
pii: openhrt-2019-001048
pmc: PMC6615850
doi:
Types de publication
Journal Article
Research Support, Non-U.S. Gov't
Langues
eng
Pagination
e001048Déclaration de conflit d'intérêts
Competing interests: OH, AB and JS are employed by Sphingotec GmbH, the company that provides the penKid and bio-ADM assays used in this study. EB is an employee of Astra Zeneca.
Références
Endocr Rev. 2000 Apr;21(2):138-67
pubmed: 10782362
J Card Fail. 2000 Jun;6(2):120-9
pubmed: 10908086
Heart Lung Circ. 2003;12(3):178-87
pubmed: 16352129
Emerg Med J. 2008 Apr;25(4):205-9
pubmed: 18356349
J Am Coll Cardiol. 2008 Nov 4;52(19):1527-39
pubmed: 19007588
Crit Care. 2010;14(3):R116
pubmed: 20550660
Congest Heart Fail. 2010 Sep-Oct;16(5):221-5
pubmed: 20887619
J Am Coll Cardiol. 2014 Jan 28;63(3):280-9
pubmed: 24140658
Crit Care. 2014 Feb 17;18(1):R34
pubmed: 24533868
Eur Heart J. 2014 Dec 21;35(48):3413-6
pubmed: 25157110
J Nephrol. 2015 Dec;28(6):717-24
pubmed: 25486879
Clin Nephrol. 2015 Jan;83(1):29-35
pubmed: 25512100
Arch Cardiovasc Dis. 2015 Jan;108(1):64-74
pubmed: 25534886
Am J Emerg Med. 2016 Feb;34(2):257-62
pubmed: 26577429
J Cardiovasc Med (Hagerstown). 2017 Jan;18(1):42-50
pubmed: 26766169
Am J Cardiol. 2016 Apr 15;117(8):1310-4
pubmed: 26916537
Int J Cardiol. 2016 Sep 1;218:120-125
pubmed: 27232923
Scand J Clin Lab Invest. 2016 Nov;76(7):568-574
pubmed: 27622713
J Card Fail. 2017 Mar;23(3):231-239
pubmed: 27663098
Ann Intensive Care. 2017 Dec;7(1):6
pubmed: 28050899
J Am Coll Cardiol. 2017 Jan 3;69(1):56-69
pubmed: 28057251
JAMA. 2017 Aug 22;318(8):713-720
pubmed: 28829876
Shock. 2018 Aug;50(2):132-140
pubmed: 29324626
Shock. 2018 Dec;50(6):648-654
pubmed: 29324627
Eur J Heart Fail. 2018 Sep;20(9):1363-1365
pubmed: 29932477