Stable state MR-proadrenomedullin level is a strong predictor for mortality in COPD patients.
Chest. 2013 Sep 26;
Authors: Zuur-Telgen MC, Brusse-Keizer MG, Vandervalk PD, van der Palen J, Kerstjens HA, Hendrix MG
Abstract
ABSTRACT BACKGROUND Midrange-proadrenomedullin (MR-proADM) has been shown to be elevated in patients hospitalized for an acute exacerbation of COPD (AECOPD) and in patients with community acquired pneumonia. MR-proADM when measured during AECOPD has also been shown to be a predictor for mortality, we hypothesized that MR-proADM levels measured in a stable state could also predict mortality. METHODS We included 181 patients in whom we had paired plasma samples for MR-proADM determinations during stable state and at hospitalization for AECOPD when they also produced sputum. Time to death or censoring was compared between patients with MR-proADM above or below the median of 0.71 nmol/L. The predictive value of MR-proADM for survival was determined by calculating the C statistic. RESULTS COPD patients with MR-proADM levels > 0.71 nmol/L in stable state had a 3-fold higher risk of dying than patients with MR-proADM levels < 0.71 nmol/L (HR 2.98 (95% CI 1.51-5.90); C statistic 0.76). The corrected Odds Ratio for one year mortality was 8.90 (95% CI 1.94 - 44.6) in patients with high MR-proADM levels measured in stable state, compared to patients with low levels. CONCLUSIONS MR-proADM measured in stable state showed to be a strong predictor for mortality in COPD patients. MR-proADM is far more convenient to measure than other predictors for mortality in COPD such as the BODE score.
PMID: 24077118 [PubMed - as supplied by publisher]