Midregional pro-atrial natriuretic peptide as a prognostic marker in pneumonia.
OBJECTIVE
To evaluate the usefulness of midregional pro-atrial natriuretic peptide (MR-proANP) measurement in the stratification of severity in community-acquired pneumonia.


METHODS
The population studied was three hundred patients admitted to Emergency Department of a tertiary university hospital presenting clinical signs of lower respiratory tract infection, a new infiltrate on the chest radiograph and a confirmed pneumonia by clinical evolution. Patients were stratified by the Pneumonia Severity Index (PSI), by CURB-65 score and by the development of complications. Serum samples were obtained at the moment of admission and prior to antibiotic therapy, and stored until analysis. MR-proANP was measured by B.R.A.H.M.S MR-proANP KRYPTOR.


RESULTS
Serum levels of MR-proANP increased with the severity of pneumonia, according to PSI score and CURB-65 score. Median MR-proANP levels were significantly higher (p<0.0001) in patients with high PSI risk class (IV-V) than in those with low PSI risk class (I-III). MR-proANP levels were also significantly higher (p=0.029) in those patients that developed complications or died. There was no association between MR-proANP and etiology of pneumonia and the radiographic extent.


CONCLUSIONS
We can conclude that MR-proANP measurement was helpful for individual risk assessment in patients with pneumonia admitted to the emergency department.
Prat
Cristina
C
Servei de Microbiologia, Hospital Universitari Germans Trias i Pujol, Badalona, Spain. cprat.germanstrias@gencat.net
Lacoma
Alicia
A
Dominguez
Josep
J
Papassotiriou
Jana
J
Morgenthaler
Nils G
NG
Andreo
Felipe
F
Tudela
Pere
P
Ruiz-Manzano
Juan
J
Ausina
Vicente
V
D000368:Aged; D009320:Atrial Natriuretic Factor / Q000097:blood*; D017714:Community-Acquired Infections / Q000150:complications / Q000175:diagnosis* / Q000401:mortality; D005260:Female; D006801:Humans; D008168:Lung / Q000000981:diagnostic imaging; D008297:Male; D011014:Pneumonia / Q000150:complications / Q000175:diagnosis* / Q000401:mortality; D011379:Prognosis; D011859:Radiography; D012720:Severity of Illness Index