Elevated MR-proANP plasma concentrations are associated with sepsis and predict mortality in critically ill patients

Figures

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  Fig. 1. MR-proANP levels in critically ill patients MR-proANP plasma concentrations are significantly elevated in critically ill patients compared with healthy controls. p value (U-test) is given

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  Fig. 2. MR-proANP levels are elevated in critically ill patients with sepsis and correlate with inflammatory markers a ICU patients with sepsis displayed significantly elevated MR-proANP levels compared to patients without sepsis. b Receiver operating characteristic (ROC) curve analyses comparing the diagnostic power in predicting sepsis of MR-proANP (black line, area under the curve (AUC) 0.656) with classical markers of inflammation and bacterial infection, C-reactive protein (CRP, grey line, AUC 0.847) and white blood cell count (leukocytes, dotted grey line, AUC 0.585). c–d MR-proANP correlates with experimental markers of inflammation in critical illness like soluble urokinase-type plasminogen activator receptor (suPAR, C) and N-terminal pro C-type natriuretic peptide (NT-proCNP, D). e At ICU admission, MR-proANP levels are significantly elevated in critically ill patients with high initial Acute Physiology and Chronic Health Evaluation (APACHE II) score (> 10) in comparison to patients with low APACHE-II scores (≤ 10). p-values (U-test or Spearman rank correlation) are given

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  Fig. 3. MR-proANP levels are not related to metabolic comorbidities a–b MR-proANP plasma concentrations in ICU patients are neither associated with pre-existing type 2 diabetes a nor obesity, as defined by a body-mass index (BMI) above 30 kg/m2b. c–d We observed significant correlations between MR-proANP and several adipocytokines including resistin (c) and adiponectin (d). p-values (U-test or Spearman rank correlation) are given

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  Fig. 4. MR-proANP is a biomarker for mortality in critically ill patients a Patients that died during or after ICU treatment displayed significant higher MR-proANP levels at ICU admission compared to patients that survived in the long-term follow-up. b High vs. low MR-proANP plasma concentrations discriminated survival of the critically ill patients, as displayed by Kaplan–Meier survival curve analysis for MR-proANP separated into quartiles. c Elevated MR-proANP plasma concentrations at ICU admission (optimal cut-off: 227.0 pmol/l) predicted the overall mortality in critically ill patients. p-values (U-test or log rank test) are given