title: Midregional proadrenomedullin for prediction of cardiovascular events in coronary artery disease: results from the AtheroGene study.
abstract: BACKGROUND
  Midregional proadrenomedullin (MR-proADM) is a newly identified prognostic marker in heart failure. We evaluated the prognostic impact of MR-proADM in a cohort of patients with symptomatic coronary artery disease according to their clinical presentation.
  
  
  METHODS
  We measured baseline MR-proADM concentrations in 2240 individuals from the prospective AtheroGene study and evaluated the prognostic impact on future fatal and nonfatal cardiovascular events during a follow-up period of 3.6 (1.6) years.
  
  
  RESULTS
  The sample comprised 1355 individuals with stable angina pectoris (SAP) and 885 with acute coronary syndrome (ACS). A cardiovascular event occurred in 192 people. Individuals presenting with SAP had only slightly lower plasma MR-proADM concentrations than those with ACS (0.53 vs 0.55 nmol/L, P=0.006). MR-proADM showed a moderate association with age, serum N-terminal pro-B-type natriuretic peptide (NT-proBNP), glomerular filtration rate, serum C-reactive protein, hypertension, diabetes, and prevalent multivessel disease (all P<0.0005). Individuals suffering from a cardiovascular event had higher MR-proADM concentrations at baseline in both groups (SAP 0.63 vs 0.53 nmol/L and ACS 0.65 nmol/L vs 0.55 nmol/L, both P<0.0005). Cox regression analysis incorporating various variables of cardiovascular risk and NT-proBNP revealed a hazard ratio of 1.4 (95% CI 1.2-1.6; P<0.0005) per increment of MR-proADM by 1SD. In risk models for secondary prevention, MR-proADM provided information comparable to that of NT-proBNP.
  
  
  CONCLUSIONS
  MR-proADM is an independent predictor for future cardiovascular events in patients with symptomatic coronary artery disease, providing information comparable to NT-proBNP for secondary risk stratification.
authors: Department of Medicine II, University Medical Center Mainz, Johannes Gutenberg-University Mainz, Germany.
authors: Philipp S
authors: PS
authors: Wild
authors: Renate B
authors: RB
authors: Schnabel
authors: Edith
authors: E
authors: Lubos
authors: Tanja
authors: T
authors: Zeller
authors: Christoph R
authors: CR
authors: Sinning
authors: Till
authors: T
authors: Keller
authors: Stergios
authors: S
authors: Tzikas
authors: Karl J
authors: KJ
authors: Lackner
authors: Dirk
authors: D
authors: Peetz
authors: Hans J
authors: HJ
authors: Rupprecht
authors: Christoph
authors: C
authors: Bickel
authors: Nils G
authors: NG
authors: Morgenthaler
authors: Jana
authors: J
authors: Papassotiriou
authors: Laurence
authors: L
authors: Tiret
authors: Thomas
authors: T
authors: Münzel
authors: Stefan
authors: S
authors: Blankenberg
mesh_terms: D054058:Acute Coronary Syndrome / Q000175:diagnosis / Q000401:mortality / Q000503:physiopathology; D053607:Adrenomedullin / Q000097:blood*; D000368:Aged; D000787:Angina Pectoris / Q000175:diagnosis / Q000401:mortality / Q000503:physiopathology; D015415:Biomarkers / Q000097:blood; D003324:Coronary Artery Disease / Q000175:diagnosis* / Q000401:mortality / Q000503:physiopathology; D005260:Female; D006801:Humans; D007118:Immunoassay; D053208:Kaplan-Meier Estimate; D008163:Luminescent Measurements; D008297:Male; D008875:Middle Aged; D020097:Natriuretic Peptide, Brain / Q000097:blood; D010446:Peptide Fragments / Q000097:blood; D011237:Predictive Value of Tests; D011379:Prognosis; D011446:Prospective Studies; D011498:Protein Precursors / Q000097:blood*; D018570:Risk Assessment
chemical_list: D015415:Biomarkers; D010446:Peptide Fragments; D011498:Protein Precursors; C109794:pro-brain natriuretic peptide (1-76); C088633:proadrenomedullin; D020097:Natriuretic Peptide, Brain; D053607:Adrenomedullin