Objective: Mid-regional pro-adrenomedullin is a biomarker reflecting endothelial dysfunction and vascular stress, extensively studied in critically ill patients. Its role in stable patients with chronic cardiovascular disease remains unclear. This study aimed to evaluate the association between mid-regional pro-adrenomedullin and selected cardiovascular complications in a stable internal medicine population. Design and method: This cross-sectional study included 157 adult patients hospitalized in a tertiary internal medicine department. The cohort comprised 140 patients with documented cardiovascular disease and 17 controls without cardiovascular disease or history of COVID-19. Plasma mid-regional pro-adrenomedullin concentrations were measured using a standardized commercial immunoassay. Logistic regression models were applied to assess associations between mid-regional pro-adrenomedullin and chronic heart failure as well as prior myocardial infarction. Model fit was evaluated using Nagelkerke R2. Results: Mid-regional pro-adrenomedullin concentration was not a significant predictor of chronic heart failure (χ2(1) = 0.19, p = 0.660; Nagelkerke R2 = 0.002) or myocardial infarction (χ2(1) = 0.51, p = 0.477; Nagelkerke R2 = 0.006). Median mid-regional pro-adrenomedullin values were numerically higher in patients with cardiovascular disease compared to controls, indicating a trend without statistical significance. Overall, the models demonstrated negligible explanatory power. Conclusions: In a stable internal medicine population with chronic cardiovascular disease, mid-regional pro-adrenomedullin showed limited association with established cardiovascular complications. These findings suggest that the clinical utility of mid-regional pro-adrenomedullin may be context-dependent and more pronounced in acute or unstable conditions rather than in stable patients.
Pietraszko et al. (Fri,) studied this question.