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BMC Cardiovasc Disord. 2017 Jul 4;17(1):178. doi: 10.1186/s12872-017-0605-3.

Pro-Adrenomedullin predicts 10-year all-cause mortality in community-dwelling patients: a prospective cohort study.

Author information

1
Department of Endocrinology, Diabetology and Metabolism, Medical University Clinic, Kantonsspital Aarau and University of Basel, Switzerland, Tellstrasse, CH-5001, Aarau, Switzerland.
2
Department of Endocrinology, Diabetology and Metabolism, Department of Clinical Research, University Hospital Basel, Basel, Switzerland.
3
Department of Clinical Research, Basel Institute for Clinical Epidemiology and Biostatistics, University Hospital Basel, Basel, Basel-Stadt, Switzerland.
4
Department of Clinical Epidemiology and Biostatistics, McMaster University, Hamilton, ON, Canada.
5
Department of Endocrinology, Diabetology and Metabolism, Medical University Clinic, Kantonsspital Aarau and University of Basel, Switzerland, Tellstrasse, CH-5001, Aarau, Switzerland. schuetzph@gmail.com.

Abstract

BACKGROUND:

Several studies found mid-regional pro-adrenomedullin (ProADM), the prohormone of the cardiovascular protein adrenomedullin, to be strongly associated with short-term mortality, mostly in the inpatient setting. We evaluated associations of ProADM levels with 10-year mortality in community-dwelling primary care patients with respiratory tract infections.

METHODS:

This is a post-hoc analysis using clinical and biomarker data of 134 primary care patients with respiratory tract infections. ProADM was measured on admission and after 7 days in batch-analysis. 10-year follow-up data was collected by GP, patient and relative tracing through phone interviews. We calculated Cox regression models and area under the receiver operating characteristics curves to assess associations of ProADM with 10-year all-cause mortality.

RESULTS:

During the 10-year follow-up 6% of included patients died. Median baseline ProADM blood levels (nmol/l) were significantly higher in non-survivors compared to survivors (0.5, IQR 0.4-1.3; vs. 0.2, IQR 0.1-0.5; p = 0.02) and showed a significant association with 10-year all-cause mortality in an age-adjusted cox regression model (HR: 2.5, 95%-CI: 1.0-6.1, p = 0.04). ProADM levels on day 7 showed similar results.

CONCLUSIONS:

This posthoc analysis found an association of elevated ProADM blood levels and 10-year all-cause mortality in a primary care cohort with respiratory tract infections. Due to the methodological limitations including incomplete data regarding follow-up information and biomarker measurement, this study warrants validation in future larger studies.

TRIAL REGISTRATION:

Current Controlled Trials, SRCTN73182671.

KEYWORDS:

10-year follow-up; Outcome; Primary care; Pro-Adrenomedullin

PMID:
28676115
PMCID:
PMC5496393
DOI:
10.1186/s12872-017-0605-3
[Indexed for MEDLINE]
Free PMC Article

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