Document Detail


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.
MedLine Citation:
PMID:  20335288     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
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.
Authors:
Stefan Kr?ger; Santiago Ewig; Jan Kunde; Oliver Hartmann; Norbert Suttorp; Tobias Welte;
Related Documents :
20153308 - Prognostic value of established and novel biomarkers in patients with shortness of brea...
20535718 - The association of functional mitral regurgitation and anemia in patients with non-isch...
2153968 - Immunohistochemical localization of renal mineralocorticoid receptor by using an anti-i...
19963668 - High resolution system for improved transient-evoked otoacoustic emission acquisition.
12109658 - Virtual endoscopy: current perspectives.
19590618 - The current role of pet-ct in the characterization of hepatobiliary malignancies.
Publication Detail:
Type:  Evaluation Studies; Journal Article; Multicenter Study; Research Support, Non-U.S. Gov't    
Journal Detail:
Title:  Thorax     Volume:  65     ISSN:  1468-3296     ISO Abbreviation:  Thorax     Publication Date:  2010 Mar 
Date Detail:
Created Date:  2010-03-25     Completed Date:  2010-05-17     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  0417353     Medline TA:  Thorax     Country:  England    
Other Details:
Languages:  eng     Pagination:  208-14     Citation Subset:  IM    
Affiliation:
Medical Clinic I, Medical Faculty, RWTH University Aachen, Germany.
Export Citation:
APA/MLA Format     Download EndNote     Download BibTex
MeSH Terms
Descriptor/Qualifier:
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:
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


Previous Document:  Evidence against a gateway from smokeless tobacco use to smoking.
Next Document:  COPD and chronic bronchitis risk of indoor air pollution from solid fuel: a systematic review and me...