Prognostic value of PCT, copeptin, MR-proADM, MR-proANP and CT-proET-1 for severe acute dyspnea in the emergency department: the BIODINER study.
BACKGROUND
Acute dyspnea is a frequent complaint in patients attending the emergency department (ED).


OBJECTIVE
To evaluate the accuracy of PCT, MR-proANP, MR-proADM, copeptin and CT-proET1 for the risk-stratification of severe acute dyspnea patients presenting to the ED.


METHODS
Multicenter prospective study in adult patients with a chief complaint of acute dyspnea. Pro-hormone type biomarkers concentrations were measured on arrival. Combined primary endpoint was a poor outcome.


RESULTS
Three hundred and ninety-four patients were included, 137 (35%) met the primary endpoint. MR-proADM was the only biomarker associated with the primary endpoint (odds ratio 1.43 [95%CI: 1.13-1.82], p = 0.003) as were the presence of paradoxical abdominal breathing (odds ratio 2.48 [95%CI: 1.31-4.68]) or cyanosis (odds ratio 3.18 [1.46-6.89]) Conclusions: In patients with severe acute dyspnea in the ED, pro-hormone type biomarkers measurements have a low added value to clinical signs for the prediction of poor outcome.
a Sorbonne Universités UPMC-Univ Paris06, UMRS INSERM 1166, IHU ICAN , GRC BIOSFAST, Paris , France.|b Emergency Department, Groupe Hospitalier Pitié-Salpêtrière, Assistance Publique-Hôpitaux De Paris (APHP) , Paris , France.
Pierre
P
Hausfater
c Centre Hospitalier Princesse Grace, Monaco.
Yann-Erick
YE
Claessens
d SAMU 44 CHU Hôtel-Dieu , Nantes Cedex 01 , France.
Arnaud
A
Martinage
e Emergency Department, CHU De Rouen, Hôpital Charles Nicolle Et Faculté De Médecine De Rouen , Rouen Cedex , France.
Luc-Marie
LM
Joly
f Emergency Department, CHRU Poitiers La Miletrie , Poitiers , France.
Jean-Yves
JY
Lardeur
g Emergency Department , Hôpital Hôtel-Dieu, AP-HP , Paris Cedex 4 , France.
Guillaume
G
Der Sahakian
h Emergency Department , CHR Lille-Hôpital B , Lille Cedex.
Claire
C
Lemanski
a Sorbonne Universités UPMC-Univ Paris06, UMRS INSERM 1166, IHU ICAN , GRC BIOSFAST, Paris , France.|i Emergency Department, Hôpital Tenon, AP-HP , Paris Cedex 20 , France.
Patrick
P
Ray
a Sorbonne Universités UPMC-Univ Paris06, UMRS INSERM 1166, IHU ICAN , GRC BIOSFAST, Paris , France.|b Emergency Department, Groupe Hospitalier Pitié-Salpêtrière, Assistance Publique-Hôpitaux De Paris (APHP) , Paris , France.
Yonathan
Y
Freund
a Sorbonne Universités UPMC-Univ Paris06, UMRS INSERM 1166, IHU ICAN , GRC BIOSFAST, Paris , France.|b Emergency Department, Groupe Hospitalier Pitié-Salpêtrière, Assistance Publique-Hôpitaux De Paris (APHP) , Paris , France.
Bruno
B
Riou
D000208:Acute Disease; D053607:Adrenomedullin / Q000032:analysis; D009320:Atrial Natriuretic Factor / Q000032:analysis; D015415:Biomarkers / Q000032:analysis; D002116:Calcitonin / Q000032:analysis; D004417:Dyspnea / Q000175:diagnosis*; D004636:Emergency Service, Hospital; D019332:Endothelin-1 / Q000032:analysis; D006020:Glycopeptides / Q000032:analysis; D006728:Hormones / Q000032:analysis*; D006801:Humans; D010446:Peptide Fragments / Q000032:analysis; D011379:Prognosis; D011446:Prospective Studies; D012720:Severity of Illness Index
D015415:Biomarkers; C557077:C-terminal proendothelin-1; D019332:Endothelin-1; D006020:Glycopeptides; D006728:Hormones; D010446:Peptide Fragments; C048197:copeptins; D053607:Adrenomedullin; D009320:Atrial Natriuretic Factor; D002116:Calcitonin
Biomarker; copeptin; dyspnea; emergency department; midregional; midregional pro-A-type natriuretic peptid; pro-adrenomedullin; pro-endothelin1; procalcitonin