title: Plasma urocortin in acute myocardial infarction patients.
abstract: BACKGROUND
  Despite its proposed cardioprotective effect, the role of plasma urocortin in acute myocardial infarction (AMI) remains unknown. We investigated plasma profile of urocortin in AMI patients and evaluated its long-term prognostic performance.
  
  
  METHODS
  Sixty-six AMI patients and 21 healthy subjects were included in this study. Blood samples for urocortin were collected on days 0 (onset), 1, 3 and 5 and at 3 and 6 months. Primary endpoint was mortality within 1 year of follow-up. Secondary endpoint was combined death and nonfatal adverse cardiac events (i.e. myocardial reinfarction, urgent revascularization or hospitalization due to heart failure) within 1 year.
  
  
  RESULTS
  During follow-up at 1 year, 38 (57·6%) patients were alive without cardiac events, nine (13·6%) had nonfatal cardiac events and 17 (25·8%) died. Plasma urocortin in AMI patients were increased on days 0, 1, 3 and 5 (P<0·05 vs. control). The receiver-operating characteristic curve showed an area under curve (AUC) of day 0 urocortin to be 0·750 with 95% confidence interval (CI) of 0·619-0·881 (P=0·004), whereas AUC of NT-proBNP was 0·857 (95% CI, 0·722-0·992; P=0·003). Sensitivity values for predicting the mortality of urocortin NT-proBNP and a combined urocortin and NT-proBNP were 0·81 (95% CI, 0·54-0·95), 0·86 (95% CI, 0·42-0·99) and 1·0 (95% CI, 0·56-1·0), respectively.
  
  
  CONCLUSIONS
  Plasma urocortin level is elevated in AMI patients for 5 days from onset. High plasma urocortin within 24 h after the onset is associated with increased mortality. Combined urocortin and NT-proBNP enhance prognostic performance in AMI patients.
authors.affiliation: Cardiac Electrophysiology Research and Training Center, Cardiology Division, Department of Internal Medicine, Chiang Mai University, Chiang Mai, Thailand.
authors.forename: Arintaya
authors.initials: A
authors.lastname: Phrommintikul
authors.forename: Sivaporn
authors.initials: S
authors.lastname: Sivasinprasasn
authors.forename: Narissara
authors.initials: N
authors.lastname: Lailerd
authors.forename: Siriporn
authors.initials: S
authors.lastname: Chattipakorn
authors.forename: Srun
authors.initials: S
authors.lastname: Kuanprasert
authors.forename: Nipon
authors.initials: N
authors.lastname: Chattipakorn
mesh_terms: D000208:Acute Disease; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D016022:Case-Control Studies; D004812:Epidemiologic Methods; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D009203:Myocardial Infarction / Q000097:blood* / Q000378:metabolism / Q000401:mortality; D020097:Natriuretic Peptide, Brain / Q000097:blood* / Q000378:metabolism; D010446:Peptide Fragments / Q000097:blood* / Q000378:metabolism; D011379:Prognosis; D054832:Urocortins / Q000097:blood* / Q000378:metabolism
chemical_list: D010446:Peptide Fragments; D054832:Urocortins; C109794:pro-brain natriuretic peptide (1-76); D020097:Natriuretic Peptide, Brain