Key result
MR-proADM was the only biomarker associated with a poor outcome (OR 1.43; 95% CI 1.13-1.82; p=0.003), but overall pro-hormone biomarkers had low added value to clinical signs for risk stratification.
Why the study?
Do pro-hormone type biomarkers (PCT, MR-proANP, MR-proADM, copeptin, CT-proET1) improve risk-stratification for poor outcomes in adult patients presenting to the ED with severe acute dyspnea?
Observational (n=394)
Yes
Do pro-hormone type biomarkers (PCT, MR-proANP, MR-proADM, copeptin, CT-proET1) improve risk-stratification for poor outcomes in adult patients presenting to the ED with severe acute dyspnea?
In patients with severe acute dyspnea in the ED, pro-hormone biomarkers like MR-proADM offer little incremental prognostic value over standard clinical signs.
Answers are grounded in this paper and cite their sources.
MR-proADM association with poor outcomes is hypothesis-generating; leaves open whether pro-hormone biomarkers add value beyond clinical signs.
CONTEXT: Acute dyspnea is a frequent complaint in patients attending the emergency department (ED). OBJECTIVE: To evaluate the accuracy of PCT, MR-proANP, MR-proADM, copeptin and CT-proET1 for the risk-stratification of severe acute dyspnea patients presenting to the ED. METHODS: Multicenter prospective study in adult patients with a chief complaint of acute dyspnea. Pro-hormone type biomarkers concentrations were measured on arrival. Combined primary endpoint was a poor outcome. RESULTS: Three hundred and ninety-four patients were included, 137 (35%) met the primary endpoint. MR-proADM was the only biomarker associated with the primary endpoint (odds ratio 1.43 [95%CI: 1.13-1.82], p = 0.003) as were the presence of paradoxical abdominal breathing (odds ratio 2.48 [95%CI: 1.31-4.68]) or cyanosis (odds ratio 3.18 [1.46-6.89]) Conclusions: In patients with severe acute dyspnea in the ED, pro-hormone type biomarkers measurements have a low added value to clinical signs for the prediction of poor outcome.
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Hausfater et al. (2016) conducted an observational in Severe acute dyspnea (n=394). Pro-hormone type biomarkers (including MR-proADM) was evaluated on Poor outcome (OR 1.43, 95% CI 1.13-1.82, p=0.003). MR-proADM was the only biomarker associated with a poor outcome (OR 1.43; 95% CI 1.13-1.82; p=0.003), but overall pro-hormone biomarkers had low added value to clinical signs for risk stratification.
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