Prognostic value of pro-adrenomedullin and copeptin in acute infective endocarditis.
Adolescent
Adrenomedullin
/ blood
Adult
Aged
Aged, 80 and over
Biomarkers
/ blood
C-Reactive Protein
/ analysis
Endocarditis
/ blood
Endocarditis, Bacterial
/ blood
Female
Glycopeptides
/ blood
Hospital Mortality
Humans
Male
Middle Aged
Procalcitonin
/ blood
Prognosis
Protein Precursors
/ blood
Retrospective Studies
Staphylococcal Infections
/ blood
Streptococcal Infections
/ blood
Young Adult
Biomarkers
Heart failure
Heart valve disease
Mortality
Organ dysfunction
Journal
BMC infectious diseases
ISSN: 1471-2334
Titre abrégé: BMC Infect Dis
Pays: England
ID NLM: 100968551
Informations de publication
Date de publication:
07 Jan 2021
07 Jan 2021
Historique:
received:
02
09
2020
accepted:
24
11
2020
entrez:
8
1
2021
pubmed:
9
1
2021
medline:
10
4
2021
Statut:
epublish
Résumé
Infective endocarditis (IE) is a life-threatening disease whose prognosis is often difficult to predict based on clinical data. Biomarkers have been shown to favorably affect disease management in a number of cardiac disorders. Aims of this retrospective study were to assess the prognostic role of procalcitonin (PCT), pro-adrenomedullin (pro-ADM) and copeptin in IE and their relation with disease characteristics and the traditional biomarker C-reactive protein (CRP). We studied 196 patients with definite IE. Clinical, laboratory and echocardiography parameters were analyzed, with a focus on co-morbidities. PCT, pro-ADM and copeptin were measured on stored plasma samples obtained on admission during the acute phase of the disease. Pro-ADM and copeptin were significantly higher in older patients and associated with prior chronic kidney disease. Pro-ADM was an independent predictor of hospital mortality (OR 3.29 [95%C.I. 1.04-11.5]; p = 0.042) whilst copeptin independently predicted 1-year mortality (OR 2.55 [95%C.I. 1.18-5.54]; p = 0.017). A high PCT value was strictly tied with S. aureus etiology (p = 0.001). CRP was the only biomarker associated with embolic events (p = 0.003). Different biomarkers correlate with distinct IE outcomes. Pro-ADM and copeptin may signal a worse prognosis of IE on admission to the hospital and could be used to identify patients who need more aggressive treatment. CRP remains a low-cost marker of embolic risk. A high PCT value should suggest S. aureus etiology.
Sections du résumé
BACKGROUND
BACKGROUND
Infective endocarditis (IE) is a life-threatening disease whose prognosis is often difficult to predict based on clinical data. Biomarkers have been shown to favorably affect disease management in a number of cardiac disorders. Aims of this retrospective study were to assess the prognostic role of procalcitonin (PCT), pro-adrenomedullin (pro-ADM) and copeptin in IE and their relation with disease characteristics and the traditional biomarker C-reactive protein (CRP).
METHODS
METHODS
We studied 196 patients with definite IE. Clinical, laboratory and echocardiography parameters were analyzed, with a focus on co-morbidities. PCT, pro-ADM and copeptin were measured on stored plasma samples obtained on admission during the acute phase of the disease.
RESULTS
RESULTS
Pro-ADM and copeptin were significantly higher in older patients and associated with prior chronic kidney disease. Pro-ADM was an independent predictor of hospital mortality (OR 3.29 [95%C.I. 1.04-11.5]; p = 0.042) whilst copeptin independently predicted 1-year mortality (OR 2.55 [95%C.I. 1.18-5.54]; p = 0.017). A high PCT value was strictly tied with S. aureus etiology (p = 0.001). CRP was the only biomarker associated with embolic events (p = 0.003).
CONCLUSIONS
CONCLUSIONS
Different biomarkers correlate with distinct IE outcomes. Pro-ADM and copeptin may signal a worse prognosis of IE on admission to the hospital and could be used to identify patients who need more aggressive treatment. CRP remains a low-cost marker of embolic risk. A high PCT value should suggest S. aureus etiology.
Identifiants
pubmed: 33413127
doi: 10.1186/s12879-020-05655-7
pii: 10.1186/s12879-020-05655-7
pmc: PMC7791699
doi:
Substances chimiques
Biomarkers
0
Glycopeptides
0
Procalcitonin
0
Protein Precursors
0
copeptins
0
proadrenomedullin
0
Adrenomedullin
148498-78-6
C-Reactive Protein
9007-41-4
Types de publication
Journal Article
Langues
eng
Sous-ensembles de citation
IM
Pagination
23Subventions
Organisme : Ministero dell'Istruzione, dell'Università e della Ricerca
ID : basic grant
Organisme : Università degli Studi della Campania Luigi Vanvitelli (IT)
ID : grant
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