Mid-Region Pro-Adrenomedullin Adds Predictive Value to Clinical Predictors and Framingham Risk Score for Long-Term Mortality in Stable Outpatients with Heart Failure
Key result
Elevated MR-proADM independently predicted long-term all-cause mortality in stable heart failure outpatients, particularly in stage A (HR 3.780, P<0.001) and stage C/D (HR 2.744, P<0.001).
Why the study?
Does elevated mid-region prohormone adrenomedullin (MR-proADM) predict long-term all-cause mortality in stable outpatients with heart failure?
Population
724 stable outpatients with heart failure, average age 68 ± 12 years.
Design
Cohort
Follow-up
up to 6 years
Authors
Discussion
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Overview
May support risk stratification in stable HF outpatients; leaves open whether it alters management or outcomes.
Key Points
- To assess the long-term prognostic utility of mid-region pro-adrenomedullin (MR-proADM) for predicting all-cause mortality in stable outpatients across stages of heart failure.
- Assessed baseline echocardiograms and serum concentrations of MR-proADM and BNP in 724 stable outpatients (198 stage A, 328 stage B, 200 stage C/D; mean age 68 ± 12 years).
- Followed patients for up to 6 years to evaluate the primary endpoint of all-cause mortality.
- A total of 195 deaths occurred over 6 years, with MR-proADM independently predicting all-cause mortality after adjustment for BNP, structural echocardiographic measures, and the Framingham risk score.
- Elevated MR-proADM significantly increased mortality risk in stage A (HR 3.780, P < 0.001) and stage C/D heart failure (HR 2.744, P < 0.001), with a borderline association in stage B (HR 1.579, P = 0.05005).
Study Design
Type
Cohort (n=724)
Structured PICO
Does elevated mid-region prohormone adrenomedullin (MR-proADM) predict long-term all-cause mortality in stable outpatients with heart failure?
P
Population
724 stable outpatients with stage A-D heart failure, mean age 68 years, followed for up to 6 years.
E
Exposure
Mid-region prohormone adrenomedullin (MR-proADM) measurement
O
Outcome
All-cause mortality at up to 6 years follow-uphard clinical
Main Result
Hazard Ratio: 3.78
p-value: p=<0.001
MR-proADM is a potent independent predictor of long-term all-cause mortality in stable outpatients across stages A-D of heart failure, adding incremental value to standard clinical predictors.
Cite This Study
Yang et al. (2013) conducted a cohort in Heart failure (n=724). Elevated mid-region prohormone adrenomedullin (MR-proADM) vs. Lower MR-proADM levels was evaluated on all-cause mortality (HR 3.780, p=<0.001). Elevated MR-proADM independently predicted long-term all-cause mortality in stable heart failure outpatients, particularly in stage A (HR 3.780, P<0.001) and stage C/D (HR 2.744, P<0.001).