Advanced

Bioactive adrenomedullin, proenkephalin A and clinical outcomes in an acute heart failure setting

Molvin, John LU ; Jujic, Amra LU ; Navarin, Silvia; Melander, Olle LU ; Zoccoli, Giada; Hartmann, Oliver; Bergmann, Andreas; Struck, Joachim; Bachus, Erasmus LU and Di Somma, Salvatore LU , et al. (2019) In Open Heart 6(2).
Abstract

Objectives In an acute heart failure (AHF) setting, proenkephalin A 119-159 (penKid) has emerged as a promising prognostic marker for predicting worsening renal function (WRF), while bioactive adrenomedullin (bio-ADM) has been proposed as a potential marker for congestion. We examined the diagnostic value of bio-ADM in congestion and penKid in WRF and investigated the prognostic value of bio-ADM and penKid regarding mortality, rehospitalisation and length of hospital stay in two separate European AHF cohorts. Methods Bio-ADM and penKid were measured in 530 subjects hospitalised for AHF in two cohorts: Swedish HeArt and bRain failure inVESTigation trial (HARVEST-Malmö) (n=322, 30.1% female; mean age 75.1+11.1 years; 12 months follow-up)... (More)

Objectives In an acute heart failure (AHF) setting, proenkephalin A 119-159 (penKid) has emerged as a promising prognostic marker for predicting worsening renal function (WRF), while bioactive adrenomedullin (bio-ADM) has been proposed as a potential marker for congestion. We examined the diagnostic value of bio-ADM in congestion and penKid in WRF and investigated the prognostic value of bio-ADM and penKid regarding mortality, rehospitalisation and length of hospital stay in two separate European AHF cohorts. Methods Bio-ADM and penKid were measured in 530 subjects hospitalised for AHF in two cohorts: Swedish HeArt and bRain failure inVESTigation trial (HARVEST-Malmö) (n=322, 30.1% female; mean age 75.1+11.1 years; 12 months follow-up) and Italian GREAT Network Rome study (n=208, 54.8% female; mean age 78.5+9.9 years; no follow-up available). Results PenKid was associated with WRF (area under the curve (AUC) 0.65, p<0.001). In multivariable logistic regression analysis of the pooled cohort, penKid showed an independent association with WRF (adjusted OR (aOR) 1.74, p=0.004). Bio-ADM was associated with peripheral oedema (AUC 0.71, p<0.001), which proved to be independent after adjustment (aOR 2.30, p<0.001). PenKid was predictive of in-hospital mortality (OR 2.24, p<0.001). In HARVEST-Malmö, both penKid and bio-ADM were predictive of 1-year mortality (aOR 1.34, p=0.038 and aOR 1.39, p=0.030). Furthermore, bio-ADM was associated with rehospitalisation (aOR 1.25, p=0.007) and length of hospital stay (β=0.702, p=0.005). Conclusion In two different European AHF cohorts, bio-ADM and penKid perform as suitable biomarkers for early detection of congestion severity and WRF occurrence, respectively, and are associated with pertinent clinical outcomes.

(Less)
Please use this url to cite or link to this publication:
author
, et al. (More)
(Less)
organization
publishing date
type
Contribution to journal
publication status
published
subject
keywords
acute heart failure, bioactive adrenomedullin, congestion, proenkephalin, worsening renal function
in
Open Heart
volume
6
issue
2
publisher
BMJ Publishing Group
external identifiers
  • scopus:85068838957
ISSN
2053-3624
DOI
10.1136/openhrt-2019-001048
language
English
LU publication?
yes
id
a6d75945-b05a-48d9-9236-ee5e853ae714
date added to LUP
2019-07-23 12:10:40
date last changed
2019-08-14 04:42:21
@article{a6d75945-b05a-48d9-9236-ee5e853ae714,
  abstract     = {<p>Objectives In an acute heart failure (AHF) setting, proenkephalin A 119-159 (penKid) has emerged as a promising prognostic marker for predicting worsening renal function (WRF), while bioactive adrenomedullin (bio-ADM) has been proposed as a potential marker for congestion. We examined the diagnostic value of bio-ADM in congestion and penKid in WRF and investigated the prognostic value of bio-ADM and penKid regarding mortality, rehospitalisation and length of hospital stay in two separate European AHF cohorts. Methods Bio-ADM and penKid were measured in 530 subjects hospitalised for AHF in two cohorts: Swedish HeArt and bRain failure inVESTigation trial (HARVEST-Malmö) (n=322, 30.1% female; mean age 75.1+11.1 years; 12 months follow-up) and Italian GREAT Network Rome study (n=208, 54.8% female; mean age 78.5+9.9 years; no follow-up available). Results PenKid was associated with WRF (area under the curve (AUC) 0.65, p&lt;0.001). In multivariable logistic regression analysis of the pooled cohort, penKid showed an independent association with WRF (adjusted OR (aOR) 1.74, p=0.004). Bio-ADM was associated with peripheral oedema (AUC 0.71, p&lt;0.001), which proved to be independent after adjustment (aOR 2.30, p&lt;0.001). PenKid was predictive of in-hospital mortality (OR 2.24, p&lt;0.001). In HARVEST-Malmö, both penKid and bio-ADM were predictive of 1-year mortality (aOR 1.34, p=0.038 and aOR 1.39, p=0.030). Furthermore, bio-ADM was associated with rehospitalisation (aOR 1.25, p=0.007) and length of hospital stay (β=0.702, p=0.005). Conclusion In two different European AHF cohorts, bio-ADM and penKid perform as suitable biomarkers for early detection of congestion severity and WRF occurrence, respectively, and are associated with pertinent clinical outcomes.</p>},
  articleno    = {e001048},
  author       = {Molvin, John and Jujic, Amra and Navarin, Silvia and Melander, Olle and Zoccoli, Giada and Hartmann, Oliver and Bergmann, Andreas and Struck, Joachim and Bachus, Erasmus and Di Somma, Salvatore and Magnusson, Martin},
  issn         = {2053-3624},
  keyword      = {acute heart failure,bioactive adrenomedullin,congestion,proenkephalin,worsening renal function},
  language     = {eng},
  month        = {07},
  number       = {2},
  publisher    = {BMJ Publishing Group},
  series       = {Open Heart},
  title        = {Bioactive adrenomedullin, proenkephalin A and clinical outcomes in an acute heart failure setting},
  url          = {http://dx.doi.org/10.1136/openhrt-2019-001048},
  volume       = {6},
  year         = {2019},
}