ICEECE2012 Oral Communications Cardiovascular Endocrinology (6 abstracts)
Circulating adrenomedulin levels are associated with atrial natriuretic peptide and brain natriuretic peptide levels in heart failure patients
P. Holmager 1 , M. Schou 2 , M. Egstrup 3 , I. Gustafsson 4 , J. Goetze 5 , F. Gustafsson 5 , P. Hildebrandt 3 , J. Faber 1 & C. Kistorp 1
1Herlev Hospital, Herlev, Denmark; 2Hillerod Hospital, Hillerod, Denmark; 3Frederiksberg Hospital, Herlev, Denmark; 4Gentofte Hospital, Gentofte, Denmark; 5Rigshospitalet, Copenhagen, Denmark;.
Introduction: Heart failure is characterised by an up-regulation of neurohoromones, and brain natriuretic peptide (BNP) and atrial natriuretic peptide (ANP) are well-established diagnostic biomarkers with substancial prognostic value. Adrenomedullin is a vasoactive peptide and a potential biomarker of vascular injury in patients with cardiovascular disease (CVD) The aims of the present study were to investigate whether mid-regional pro adrenomedullin (MR-proADM) is predictive of outcome in heart failure (CHF) patients and if MR-proADM is associated with MR-proANP or NT-proBNP.
Materials and methods: Prospective, observational study of 360 unselected CHF patients included at baseline (30% female, mean age 71 years). 63% had CVD. Patients were followed for a median of 17 months with respect to mortality. 184 patients died and 229 were hospitalised.
Results: Mean (S.D.) MR-proADM levels were 0.75 (0.42) nmol/l, mediann (interquartile range) MR-proANP levels were 238 (149–362) nmol/l and NT-proBNP levels were 1138 (469-2636) pg/ml. MR-pro ADM was associated with age (r=0.28, P<0.001), s-creatinine (r=0.32, P<0.001), NT-proBNP (r=0.29, P < 0.001) and MR-proANP (r= 0.42, P < 0.001). Using Cox proportional hazard analysis increasing logarithmic levels of MR-proADM were predictive of mortality HR being 1.32 (1.29–1.35, P=0.007) and MR-proANP were predictive of mortality HR being 1.36 (1.33–1.39, P=0.013) after adjusting for age, gender, CVD, NYHA, systolic blood presure, LVEF and treatment with β-blocker or aldosteron antagonist. When adding NT-proBNP to the model HR of mortality was 1.21 (P=0.09) for MR-proADM and 1.13 (P=0.42) for MR-proANP.
Conclusion: MR-proADM levels were associated with both NT-proBNP and ANP. MR-proADM was predictive of mortality after adjustment for well known risk factors in CHF. Neither MR-proADM or MR-proANP was independently related with outcome after including NT-proBNP in the multivariate model.
Declaration of interest: The authors declare that there is no conflict of interest that could be perceived as prejudicing the impartiality of the research project.
Funding: This research did not receive any specific grant from any funding agency in the public, commercial or not-for-profit sector.
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Endocrine Abstracts
ISSN 1470-3947 (print) | ISSN 1479-6848 (online)
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