[Biomarkers in community acquired pneumonia - what did we learn from the CAPNETZ study?].
BACKGROUND
Biomarkers have been intensively studied in community-acquired pneumonia (CAP) in recent years. In the context of the CAPNETZ study we had the unique opportunity to evaluate old and new biomarkers in a multicentre study with a high number of patients.


RESULTS
In several substudies we found the following results: procalcitonin, CRP and leukocytes show highest values in patients with typical bacterial etiology of CAP, but do not allow individual prediction of etiology. Patients without antibiotic pre-treatment show higher values of biomarkers compared to patients with antibiotic pre-treatment. New cardiovascular biomarkers are good predictors for short- and long-term mortality in CAP, superior to the inflammatory markers procalcitonin, CRP and leukocytes and at least comparable to the clinical CRB-65 score. Pro-Adrenomedullin is among the new biomarkers the one with the best prognostic value.


CONCLUSIONS
Biomarkers correlate with the severity of CAP but do not allow individual prediction of etiology. New cardiovascular biomarkers are suitable for the evaluation of short- and long-term prognosis in CAP. The combination of several biomarkers reflecting different pathophysiological pathways has the potential to improve management of CAP in the future.
Medizinische Klinik I, Universitätsklinikum RWTH Aachen. stkrueger@ukaachen.de
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D000293:Adolescent; D053607:Adrenomedullin / Q000097:blood; D000328:Adult; D017677:Age Distribution; D000368:Aged; D000369:Aged, 80 and over; D009320:Atrial Natriuretic Factor / Q000097:blood; D015415:Biomarkers / Q000097:blood*; D001794:Blood Pressure; D002097:C-Reactive Protein; D002116:Calcitonin / Q000097:blood; D015740:Calcitonin Gene-Related Peptide; D002318:Cardiovascular Diseases / Q000097:blood* / Q000453:epidemiology*; D017714:Community-Acquired Infections / Q000097:blood* / Q000453:epidemiology; D015897:Comorbidity; D019332:Endothelin-1 / Q000097:blood; D005260:Female; D005858:Germany / Q000453:epidemiology; D006801:Humans; D007249:Inflammation / Q000097:blood*; D007958:Leukocyte Count; D008297:Male; D008875:Middle Aged; D011014:Pneumonia / Q000097:blood / Q000453:epidemiology*; D011237:Predictive Value of Tests; D011498:Protein Precursors / Q000097:blood; D056152:Respiratory Rate; D016019:Survival Analysis; D014667:Vasopressins / Q000097:blood; D055815:Young Adult
D015415:Biomarkers; C000606589:CALCA protein, human; D019332:Endothelin-1; D011498:Protein Precursors; C552580:midregional pro-atrial natriuretic peptide, human; C088633:proadrenomedullin; C093240:proendothelin 1; D014667:Vasopressins; D053607:Adrenomedullin; D009320:Atrial Natriuretic Factor; D002116:Calcitonin; D002097:C-Reactive Protein; D015740:Calcitonin Gene-Related Peptide