title: [High levels of atrial natriuretic peptide and copeptin and mortality risk].
abstract: OBJECTIVE
  To determine whether high levels of mid-regional pro-atrial natriuretic peptide (MR-proANP), copeptin, and procalcitonin (PCT) plasma concentrations are associated with increased mortality risk.
  
  
  METHODS
  Prospective observational study including 254 critically ill children. MR-proANP, copeptin and PCT were compared between children with high (Group A; n=33) and low (Group B; n=221) mortality risk, and between patients with failure of more than 1 organ (Group 1; n=71) and less than 2 (Group 2; n=183).
  
  
  RESULTS
  Median (range) of MR-proANP, copeptin, and PCT levels in group A vs B were, respectively: 209.4 (30.5-1415.8) vs. 75.0 (14.6-867.2) pmol/L (P<.001); 104.4 (7.4-460.9) vs. 26.6 (0.00-613.1) pmol/L (P<.001), and 7.8 (0.3-552.0) vs. 0.3 (0.02-107.0) ng/mL (P<.001). The area under the curve (AUC) for the differentiation of group A and B was 0.764 (95% CI: 0.674-0.854) for MR-proANP; 0.735 (0.642-0.827) for copeptin, and 0.842 (0.744-0.941) for PCT, with no statistical differences. The AUCs for the differentiation of group 1 and 2 were: 0.837 (0.784-0.891) for MR-proANP, 0.735 (0.666-0.804) for copeptin, and 0.804 (0.715-0.892) for PCT, with statistical differences between MR-proANP and copeptin, P=.01.
  
  
  CONCLUSIONS
  High levels of MR-proANP, copeptin and PCT were associated with increased mortality risk scores. MR-proANP showed a higher association than copeptin with number of organs in failure.
authors.affiliation: Unidad de Cuidados Intensivos Pediátricos, Hospital Universitario Central de Asturias, Oviedo, Asturias, España; Universidad de Oviedo, Oviedo, Asturias, España; Red SAMID II, Instituto de Salud Carlos III, Madrid, España. Electronic address: crey@uniovi.es.
authors.forename: Corsino
authors.initials: C
authors.lastname: Rey
authors.affiliation: Centro de Salud de Tomiño, Servicio Gallego de Salud, Tomiño, Pontevedra, España.
authors.forename: Clara
authors.initials: C
authors.lastname: García-Cendón
authors.affiliation: Hospital Universitario Central de Asturias, Oviedo, Asturias, España; Universidad Autónoma de Chile, Santiago, Chile.
authors.forename: Pablo
authors.initials: P
authors.lastname: Martínez-Camblor
authors.affiliation: Red SAMID II, Instituto de Salud Carlos III, Madrid, España; Servicio de Cuidados Intensivos Pediátricos, Hospital General Universitario Gregorio Marañón, Instituto de Investigación Sanitaria Gregorio Marañón, Madrid, España; Universidad Complutense, Madrid, España.
authors.forename: Jesús
authors.initials: J
authors.lastname: López-Herce
authors.affiliation: Unidad de Cuidados Intensivos Pediátricos, Hospital Universitario Central de Asturias, Oviedo, Asturias, España.
authors.forename: Andrés
authors.initials: A
authors.lastname: Concha-Torre
authors.affiliation: Unidad de Cuidados Intensivos Pediátricos, Hospital Universitario Central de Asturias, Oviedo, Asturias, España.
authors.forename: Alberto
authors.initials: A
authors.lastname: Medina
authors.affiliation: Unidad de Cuidados Intensivos Pediátricos, Hospital Universitario Central de Asturias, Oviedo, Asturias, España.
authors.forename: Ana
authors.initials: A
authors.lastname: Vivanco-Allende
authors.affiliation: Unidad de Cuidados Intensivos Pediátricos, Hospital Universitario Central de Asturias, Oviedo, Asturias, España.
authors.forename: Juan
authors.initials: J
authors.lastname: Mayordomo-Colunga
mesh_terms: D000293:Adolescent; D009320:Atrial Natriuretic Factor / Q000097:blood*; D015415:Biomarkers / Q000097:blood; D002116:Calcitonin / Q000097:blood*; D002648:Child; D002675:Child, Preschool; D016638:Critical Illness; D005260:Female; D006020:Glycopeptides / Q000097:blood*; D006801:Humans; D007223:Infant; D007231:Infant, Newborn; D008297:Male; D009102:Multiple Organ Failure / Q000097:blood* / Q000401:mortality*; D011379:Prognosis; D011446:Prospective Studies; D018570:Risk Assessment
chemical_list: D015415:Biomarkers; D006020:Glycopeptides; C048197:copeptins; D009320:Atrial Natriuretic Factor; D002116:Calcitonin
keywords: Atrial natriuretic peptide; Copeptin; Copeptina; Critically ill children; Fallo de órganos; Mortality risk; Niños críticamente enfermos; Organ failure; Procalcitonin; Procalcitonina; Prognosis; Pronóstico; Péptido natriurético auricular; Riesgo de mortalidad