title: Stable-State Midrange-Proadrenomedullin Level Is a Strong Predictor of Mortality in Patients With COPD.
abstract: Midrange-proadrenomedullin (MR-proADM) has been shown to be elevated in patients hospitalized for an acute exacerbation of COPD (AECOPD) and in patients with community-acquired pneumonia. When measured during AECOPDs, MR-proADM has also been shown to be a predictor of mortality. We hypothesized that MR-proADM levels measured in a stable state could also predict mortality.
  
  
  
  We included 181 patients in whom we had paired plasma samples for MR-proADM determinations during a stable state and at hospitalization for an AECOPD when they also produced sputum. Time to death or censoring was compared between patients with MR-proADM above or below the median of 0.71 nmol/L. The predictive value of MR-proADM for survival was determined by calculating the C statistic.
  
  
  
  Patients with COPD and MR-proADM levels > 0.71 nmol/L in the stable state had a threefold-higher risk of dying than did patients with MR-proADM levels < 0.71 nmol/L (hazard ratio, 2.98 [95% CI, 1.51-5.90]; C statistic, 0.76). The corrected OR for 1-year mortality was 8.90 (95% CI, 1.94-44.6) in patients with high MR-proADM levels measured in the stable state, compared with patients with low levels measured in the stable state.
  
  
  
  MR-proADM measured in the stable state appeared to be a strong predictor of mortality in patients with COPD. MR-proADM is far easier to measure than other predictors of mortality in COPD, such as BMI, airflow obstruction, dyspnea, and exercise capacity score.
authors.affiliation: Department of Pulmonary Medicine, Medisch Spectrum Twente, Enschede; Department of Internal Medicine, Medisch Spectrum Twente, Enschede. Electronic address: maaiketelgen@gmail.com.
authors.forename: Maaike C
authors.initials: MC
authors.lastname: Zuur-Telgen
authors.affiliation: Department of Pulmonary Medicine, Medisch Spectrum Twente, Enschede.
authors.forename: Marjolein G J
authors.initials: MG
authors.lastname: Brusse-Keizer
authors.affiliation: Department of Pulmonary Medicine, Medisch Spectrum Twente, Enschede.
authors.forename: Paul D L P M
authors.initials: PD
authors.lastname: VanderValk
authors.affiliation: Department of Pulmonary Medicine, Medisch Spectrum Twente, Enschede; Department of Pulmonary Medicine University Medical Centre Groningen, University of Groningen, Groningen.
authors.forename: Job
authors.initials: J
authors.lastname: van der Palen
authors.affiliation: Department of Research Methodology, Measurement, and Data Analysis, University of Twente, Enschede; Groningen Research Institute for Asthma and COPD (GRIAC), Groningen, The Netherlands.
authors.forename: Huib A M
authors.initials: HA
authors.lastname: Kerstjens
authors.affiliation: Regional Laboratory of Public Health, University of Twente, Enschede; Department of Medical Microbiology, University Medical Centre Groningen, University of Groningen, Groningen.
authors.forename: M G Ron
authors.initials: MG
authors.lastname: Hendrix
mesh_terms: D053607:Adrenomedullin / Q000032:analysis*; D000368:Aged; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D009026:Mortality; D009426:Netherlands / Q000453:epidemiology; D062072:Patient Acuity; D010446:Peptide Fragments / Q000032:analysis*; D011237:Predictive Value of Tests; D011379:Prognosis; D011498:Protein Precursors / Q000032:analysis*; D029424:Pulmonary Disease, Chronic Obstructive / Q000175:diagnosis / Q000378:metabolism / Q000401:mortality / Q000503:physiopathology; D015203:Reproducibility of Results; D013183:Sputum / Q000378:metabolism*
chemical_list: D010446:Peptide Fragments; D011498:Protein Precursors; C574167:mid-regional pro-adrenomedullin, human; D053607:Adrenomedullin