title: Midregional pro-atrial natriuretic peptide as a prognostic marker in pneumonia.
abstract: 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.
authors.affiliation: Servei de Microbiologia, Hospital Universitari Germans Trias i Pujol, Badalona, Spain. cprat.germanstrias@gencat.net
authors.forename: Cristina
authors.initials: C
authors.lastname: Prat
authors.forename: Alicia
authors.initials: A
authors.lastname: Lacoma
authors.forename: Josep
authors.initials: J
authors.lastname: Dominguez
authors.forename: Jana
authors.initials: J
authors.lastname: Papassotiriou
authors.forename: Nils G
authors.initials: NG
authors.lastname: Morgenthaler
authors.forename: Felipe
authors.initials: F
authors.lastname: Andreo
authors.forename: Pere
authors.initials: P
authors.lastname: Tudela
authors.forename: Juan
authors.initials: J
authors.lastname: Ruiz-Manzano
authors.forename: Vicente
authors.initials: V
authors.lastname: Ausina
mesh_terms: 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