| Pro-atrial natriuretic peptide and pro-vasopressin for predicting short-term and long-term survival in community-acquired pneumonia: results from the German Competence Network CAPNETZ. | |
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MedLine Citation:
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PMID: 20335288 Owner: NLM Status: MEDLINE |
Abstract/OtherAbstract:
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BACKGROUND: Community-acquired pneumonia (CAP) is the most important clinical infection with a high long-term mortality rate. The aim of this study was to evaluate the value of biomarkers for the prediction of short-term and long-term mortality in CAP. METHODS: A total of 1740 patients of mean + or - SD age 60 + or - 18 years (45% female) with proven CAP were enrolled in the study. Mid-regional pro-atrial natriuretic peptide (MR-proANP), C-terminal pro-atrial vasopressin (CT-proAVP), procalcitonin, C-reactive protein, leucocyte count (WBC) and CRB-65 score were determined on admission. Patients were followed up for 180 days. RESULTS: MR-proANP and CT-proAVP levels increased with increasing severity of CAP, classified according to CRB-65 score. In patients who died within 28 and 180 days, median MR-proANP (313.9 vs 80.0 and 277.8 vs 76.0 pmol/l, each p<0.0001) and CT-proAVP (42.6 vs 11.2 and 33.2 vs 10.7 pmol/l, each p<0.0001) levels were significantly higher than the levels in survivors. In receiver operating characteristics analysis for survival at 28 and 180 days, the areas under the curves (AUCs) for CT-proAVP (0.84, 95% CI 0.82 to 0.86 and 0.78, 95% CI 0.76 to 0.80) and MR-proANP (0.81, 95% CI 0.79 to 0.83 and 0.81, 95% CI 0.79 to 0.83) were superior to the AUC of CRB-65 (0.74, 95% CI 0.71 to 0.76 and 0.71, 95% CI 0.69 to 0.74, p<0.05), procalcitonin, C-reactive protein and WBC. In multivariable Cox proportional hazards regression analyses adjusted for comorbidity and pneumonia severity, MR-proANP and CT-proAVP were independent and the strongest predictors of short-term and long-term mortality. CONCLUSIONS: MR-proANP and CT-proAVP are powerful tools for the prediction of short-term and long-term risk stratification of patients with CAP. |
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Authors:
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Stefan Kr?ger; Santiago Ewig; Jan Kunde; Oliver Hartmann; Norbert Suttorp; Tobias Welte; |
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Publication Detail:
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Type: Evaluation Studies; Journal Article; Multicenter Study; Research Support, Non-U.S. Gov't |
Journal Detail:
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Title: Thorax Volume: 65 ISSN: 1468-3296 ISO Abbreviation: Thorax Publication Date: 2010 Mar |
Date Detail:
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Created Date: 2010-03-25 Completed Date: 2010-05-17 Revised Date: - |
Medline Journal Info:
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Nlm Unique ID: 0417353 Medline TA: Thorax Country: England |
Other Details:
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Languages: eng Pagination: 208-14 Citation Subset: IM |
Affiliation:
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Medical Clinic I, Medical Faculty, RWTH University Aachen, Germany. |
Export Citation:
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| MeSH Terms | |
Descriptor/Qualifier:
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Adolescent Adult Aged Aged, 80 and over Atrial Natriuretic Factor / blood* Biological Markers / blood Community-Acquired Infections / diagnosis, mortality Epidemiologic Methods Female Germany / epidemiology Humans Male Middle Aged Pneumonia / diagnosis*, mortality Prognosis Vasopressins / blood* Young Adult |
| Chemical | |
Reg. No./Substance:
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0/Biological Markers; 11000-17-2/Vasopressins; 85637-73-6/Atrial Natriuretic Factor |
From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine
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