| Prognostic value of mid-regional pro-adrenomedullin levels taken on admission and discharge in non-ST-elevation myocardial infarction: the LAMP (Leicester Acute Myocardial Infarction Peptide) II study. | |
| | |
MedLine Citation:
|
PMID: 20620726 Owner: NLM Status: MEDLINE |
Abstract/OtherAbstract:
|
OBJECTIVES: The purpose of this study was to assess the prognostic value of admission and discharge mid-regional pro-adrenomedullin (sAM) levels in non-ST-elevation myocardial infarction (MI) and identify values to aid clinical decision making. N-terminal pro-B-type natriuretic peptide and GRACE (Global Registry of Acute Coronary Events) score were used as comparators. BACKGROUND: sAM is a stable precursor of adrenomedullin. METHODS: We measured plasma sAM on admission and discharge in 745 non-ST-elevation MI patients (514 men, median age 70.0 +/- 12.7 years). The primary end point was a composite of death, heart failure, hospitalization, and recurrent acute MI over mean follow-up of 760 days (range 150 to 2,837 days), with each event assessed individually as secondary end points. RESULTS: During follow-up, 120 (16.1%) patients died, and there were 65 (8.7%) hospitalizations for heart failure and 77 (10.3%) recurrent acute MIs. Both admission and discharge levels were increased (median 0.81 nmol/l [range 0.06 to 5.75 nmol/l] and 0.76 nmol/l [range 0.25 to 6.95 nmol/l], respectively) compared with established normal ranges. Multivariate adjusted Cox regression models revealed that both were associated with the primary end point (hazard ratio: 9.75 on admission and 7.54 on discharge; both p < 0.001). Admission sAM was particularly associated with early (<30 days) mortality (c-statistic = 0.90, p < 0.001), and when compared with N-terminal pro-B-type natriuretic peptide and GRACE score, it was the only independent predictor of this end point. Admission sAM >1.11 nmol/l identified those at highest risk of death (p < 0.001). Patients with above-median admission sAM may benefit from revascularization. CONCLUSIONS: sAM level is prognostic for death or heart failure. Admission levels are a strong predictor of early mortality and, when >1.11 nmol/l, complements the GRACE score to improve risk stratification. |
| | |
Authors:
|
Onkar S Dhillon; Sohail Q Khan; Hafid K Narayan; Kelvin H Ng; Joachim Struck; Paulene A Quinn; Nils G Morgenthaler; Iain B Squire; Joan E Davies; Andreas Bergmann; Leong L Ng |
Related Documents
:
|
10088206 - An experimental study of cardiac natriuretic peptides as markers of development of cong... 10956256 - Activation of cardiorenal and pulmonary tissue endothelin-1 in experimental heart failure. 12866806 - Atenolol improves ventricular function without changing plasma noradrenaline but decrea... 20206886 - Routinely-feasible multiple biomarkers score to predict prognosis after revascularized ... 14620386 - Effects of the angiotensin ii subtype 1 receptor antagonist losartan on functional reco... 12108816 - Depression, anxiety, and the cardiovascular system: the cardiologist's perspective. |
Publication Detail:
|
Type: Comparative Study; Journal Article; Research Support, Non-U.S. Gov't |
Journal Detail:
|
Title: Journal of the American College of Cardiology Volume: 56 ISSN: 1558-3597 ISO Abbreviation: J. Am. Coll. Cardiol. Publication Date: 2010 Jul |
Date Detail:
|
Created Date: 2010-07-12 Completed Date: 2010-07-30 Revised Date: - |
Medline Journal Info:
|
Nlm Unique ID: 8301365 Medline TA: J Am Coll Cardiol Country: United States |
Other Details:
|
Languages: eng Pagination: 125-33 Citation Subset: AIM; IM |
Copyright Information:
|
Copyright 2010 American College of Cardiology Foundation. Published by Elsevier Inc. All rights reserved. |
Affiliation:
|
Department of Cardiovascular Sciences, University of Leicester, Leicester Royal Infirmary, Leicester, United Kingdom. dhillonos@hotmail.com |
Export Citation:
|
APA/MLA Format Download EndNote Download BibTex |
| MeSH Terms | |
Descriptor/Qualifier:
|
Adrenomedullin
/
blood* Aged Electrocardiography Female Follow-Up Studies Heart Failure / mortality Humans Male Myocardial Infarction / blood*, physiopathology Natriuretic Peptide, Brain / blood Patient Admission Patient Discharge Peptide Fragments / blood Prognosis Protein Precursors / blood* |
| Grant Support | |
ID/Acronym/Agency:
|
FS/03/028/15486//British Heart Foundation; FS/09/040//British Heart Foundation |
| Chemical | |
Reg. No./Substance:
|
0/Peptide Fragments; 0/Protein Precursors; 0/pro-brain natriuretic peptide (1-76); 0/proadrenomedullin; 114471-18-0/Natriuretic Peptide, Brain; 148498-78-6/Adrenomedullin |
From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine
Previous Document: Screening asymptomatic subjects for subclinical atherosclerosis: can we, does it matter, and should ...
Next Document: Cardiovascular Risk in Clopidogrel-Treated Patients According to Cytochrome P450 2C19*2 Loss-of-Func...