Pro-adrenomedullin, pro-atrial natriuretic peptide and procalcitonin levels at admission in patients with community-acquired pneumonia and its correlation with risk scores

Objectives: To assess levels of MR-proADM, MR-proANP and PCT in patients with community acquired pneumonia (CAP) and to correlate admission levels with the following severity risk scores: PSI, CURB65 and severe CAP (SCAP) and prognosis. Methods: Study population was 85 patients with diagnosis of pneumonia. Epidemiological, clinical, microbiological, analytical and radiological data were recorded. Plasma samples were collected at admission. Patients were stratified according to the PSI, CURB65 and SCAP. Complications were defined as need of ICU admission or death. Results: MR-proANP and MR-proADM showed significant differences across PSI score (p=0.001 and p=0.001) whereas no statistical differences were found for PCT (p=0.152). Regarding CURB65, MR-proANP and MR-proADM levels increased according to CURB65 score points (p=0.001 and p=0.001), but not PCT (p=0.071). Higher levels of MR-proANP (p=0.002), proADM (p=0.001) and PCT (p=0.069) were found in patients with SCAP criteria. MR-proADM (p=0.001) and MR-proANP (p=0.015) showed statistical differences when grouping SCAP in five risk groups. Levels of PCT (p=0.053) and MR-proADM (p=0.001) were significantly higher in patients admitted to ICU. Levels of all biomarkers were higher in non-survivors in comparison to survivors, although no statistical differences were found. Conclusions: Admission MR-proANP and MR-proADM levels correlate with pneumonia severity assessed by PSI, CURB65 and SCAP. PCT levels correlate with new severity SCAP index. Higher biomarkers levels can be useful for identifying patients with a poorer prognosis.