title: Comparison and evaluation of cardiac biomarkers in patients with intermittent claudication: results from the CAVASIC study.
abstract: BACKGROUND
  Plasma concentrations of the peptides midregional proadrenomedullin (MR-proADM), midregional proatrial natriuretic peptide (MR-proANP), and C-terminal endothelin-1 precursor fragment (CT-proET-1) are increased in various cardiovascular conditions. However, there is limited information about the association and comparative performance of these peptides in peripheral arterial disease (PAD).
  
  
  METHODS
  The associations of MR-proADM, MR-proANP, and CT-proET-1 plasma concentrations with symptomatic PAD were investigated in the CAVASIC (Cardiovascular Disease in Intermittent Claudication) Study. Study participants were a male cohort of 238 patients with a diagnosis of intermittent claudication (IC) and 245 age- and diabetes-matched controls. Results were compared to those for N-terminal pro-B-type natriuretic peptide (NT-proBNP).
  
  
  RESULTS
  Each increase of MR-proADM, MR-proANP, and CT-proET-1 by 1 SD was significantly associated with symptomatic PAD: odds ratio (OR) = 1.78 (95% CI, 1.41-2.25, P < 0.001), OR = 1.32 (95% CI, 1.06-1.66, P = 0.014), and OR = 1.80 (95% CI, 1.43-2.28, P < 0.001), respectively. The association remained significant for all 3 markers after additional adjustment for log C-reactive protein, serum creatinine, HDL cholesterol, and current smoking. When one adjusts for log NT-proBNP and excluding individuals with prevalent cardiovascular disease, MR-proADM and CT-proET-1 still predicted symptomatic PAD. Extended adjustment models including MR-proADM or CT-proET-1 showed significantly improved model fits compared to models including classical cardiac risk factors or NT-proBNP and led to significant reclassification (P < 0.05).
  
  
  CONCLUSIONS
  This study in a male cohort of patients with IC and age- and diabetes-matched controls indicates a significant association of high MR-proADM, MR-proANP, and CT-proET-1 concentrations with PAD. MR-proADM and CT-proET-1 provide additive information in comparison to NT-proBNP. Moreover, MR-proADM and CT-proET-1 significantly predict PAD in those patients and controls free from prevalent CVD.
authors: Division of Genetic Epidemiology, Department of Medical Genetics, Molecular and Clinical Pharmacology, Innsbruck Medical University, Innsbruck, Austria.
authors: Barbara
authors: B
authors: Kollerits
authors: Gisela
authors: G
authors: Sturm
authors: Claudia
authors: C
authors: Lamina
authors: Angelika
authors: A
authors: Hammerer-Lercher
authors: Barbara
authors: B
authors: Rantner
authors: Marietta
authors: M
authors: Stadler
authors: Tim
authors: T
authors: Ziera
authors: Joachim
authors: J
authors: Struck
authors: Peter
authors: P
authors: Klein-Weigel
authors: Gustav
authors: G
authors: Fraedrich
authors: Florian
authors: F
authors: Kronenberg
mesh_terms: D000328:Adult; D000368:Aged; D015415:Biomarkers / Q000097:blood*; D016022:Case-Control Studies; D015331:Cohort Studies; D006801:Humans; D007383:Intermittent Claudication / Q000097:blood / Q000175:diagnosis*; D016015:Logistic Models; D008297:Male; D008875:Middle Aged; D009206:Myocardium / Q000378:metabolism*; D010641:Phenotype
chemical_list: D015415:Biomarkers