Key result
Each 1 SD increase in MR-proADM, MR-proANP, and CT-proET-1 was significantly associated with symptomatic peripheral arterial disease (e.g., MR-proADM OR 1.78; 95% CI 1.41-2.25; P<0.001).
Why the study?
Do plasma concentrations of MR-proADM, MR-proANP, and CT-proET-1 predict symptomatic PAD in men with intermittent claudication compared to controls?
Case-Control (n=483)
Do plasma concentrations of MR-proADM, MR-proANP, and CT-proET-1 predict symptomatic PAD in men with intermittent claudication compared to controls?
Odds Ratio: 1.78 (95% CI 1.41–2.25)
p-value: p=<0.001
Elevated plasma concentrations of MR-proADM and CT-proET-1 are significantly associated with symptomatic PAD and provide additive predictive value over NT-proBNP and classical risk factors.
BACKGROUND: Plasma concentrations of the peptides midregional proadrenomedullin (MR-proADM), midregional proatrial natriuretic peptide (MR-proANP), and C-terminal endothelin-1 precursor fragment (CT-proET-1) are increased in various cardiovascular conditions. However, there is limited information about the association and comparative performance of these peptides in peripheral arterial disease (PAD). METHODS: The associations of MR-proADM, MR-proANP, and CT-proET-1 plasma concentrations with symptomatic PAD were investigated in the CAVASIC (Cardiovascular Disease in Intermittent Claudication) Study. Study participants were a male cohort of 238 patients with a diagnosis of intermittent claudication (IC) and 245 age- and diabetes-matched controls. Results were compared to those for N-terminal pro-B-type natriuretic peptide (NT-proBNP). RESULTS: Each increase of MR-proADM, MR-proANP, and CT-proET-1 by 1 SD was significantly associated with symptomatic PAD: odds ratio (OR) = 1.78 (95% CI, 1.41-2.25, P < 0.001), OR = 1.32 (95% CI, 1.06-1.66, P = 0.014), and OR = 1.80 (95% CI, 1.43-2.28, P < 0.001), respectively. The association remained significant for all 3 markers after additional adjustment for log C-reactive protein, serum creatinine, HDL cholesterol, and current smoking. When one adjusts for log NT-proBNP and excluding individuals with prevalent cardiovascular disease, MR-proADM and CT-proET-1 still predicted symptomatic PAD. Extended adjustment models including MR-proADM or CT-proET-1 showed significantly improved model fits compared to models including classical cardiac risk factors or NT-proBNP and led to significant reclassification (P < 0.05). CONCLUSIONS: This study in a male cohort of patients with IC and age- and diabetes-matched controls indicates a significant association of high MR-proADM, MR-proANP, and CT-proET-1 concentrations with PAD. MR-proADM and CT-proET-1 provide additive information in comparison to NT-proBNP. Moreover, MR-proADM and CT-proET-1 significantly predict PAD in those patients and controls free from prevalent CVD.
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Kollerits et al. (2013) conducted a case-control in Intermittent claudication (peripheral arterial disease) (n=483). Elevated plasma concentrations of MR-proADM, MR-proANP, and CT-proET-1 vs. Age- and diabetes-matched controls was evaluated on Symptomatic peripheral arterial disease (per 1 SD increase in MR-proADM) (OR 1.78, 95% CI 1.41-2.25, p=<0.001). Each 1 SD increase in MR-proADM, MR-proANP, and CT-proET-1 was significantly associated with symptomatic peripheral arterial disease (e.g., MR-proADM OR 1.78; 95% CI 1.41-2.25; P<0.001).
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