title: Circulating chromogranin B levels in patients with acute respiratory failure: data from the FINNALI Study.
abstract: OBJECTIVE
  Circulating chromogranin B (CgB) levels are increased in situations characterized by systemic and myocardial stress, but whether CgB provides prognostic information in patients with acute respiratory failure (ARF) is unknown.
  
  
  METHODS
  We included 584 patients with ARF, defined as ventilatory support >6 h, and with blood samples available on Intensive Care Unit (ICU) admission and day 3 (n = 479). CgB levels were measured by radioimmunoassay and follow-up was 90 days.
  
  
  RESULTS
  One-hundred-sixty-nine patients (29%) died during follow-up. Admission CgB levels separated non-survivors from survivors: median 1234 (Q1-3 989-1742) vs. 917 (753-1224) pmol/L, respectively, p < 0.001. CgB levels on ICU admission (logarithmically transformed) were associated with time to death after adjustment for established risk indices available on ICU admission, including N-terminal pro-B-type natriuretic levels: HR 2.62 (95%C.I. 1.82-3.77), p < 0.001. Admission CgB levels also improved prognostication on top of SOFA and SAPS II scores as assessed by Cox regression analyses and the category-free net reclassification index. The area under the curve (AUC) for admission CgB levels to separate survivors and non-survivors was 0.72 (95%CI 0.67-0.76), while the AUC on day 3 was 0.60 (0.54-0.66).
  
  
  CONCLUSIONS
  CgB levels measured on ICU admission provided additional prognostic information to established risk indices in ARF patients.
authors.affiliation: a Division of Medicine , Akershus University Hospital , Lørenskog , Norway.|b Center for Heart Failure Research, University of Oslo , Oslo , Norway.|c Center for Clinical Heart Research, Oslo University Hospital , Oslo , Norway.
authors.forename: Peder Langeland
authors.initials: PL
authors.lastname: Myhre
authors.affiliation: d Department of Medical Sciences , Uppsala University , Uppsala , Sweden.
authors.forename: Mats
authors.initials: M
authors.lastname: Stridsberg
authors.affiliation: e Division of Intensive Care Medicine, Department of Anesthesiology, Intensive Care and Pain Medicine , University of Helsinki and Helsinki University Hospital , Helsinki , Finland.
authors.forename: Rita
authors.initials: R
authors.lastname: Linko
authors.affiliation: e Division of Intensive Care Medicine, Department of Anesthesiology, Intensive Care and Pain Medicine , University of Helsinki and Helsinki University Hospital , Helsinki , Finland.
authors.forename: Marjatta
authors.initials: M
authors.lastname: Okkonen
authors.affiliation: f Bioinformatics core facility , Oslo University Hospital and the University of Oslo , Oslo , Norway.
authors.forename: Ståle
authors.initials: S
authors.lastname: Nygård
authors.affiliation: b Center for Heart Failure Research, University of Oslo , Oslo , Norway.|g Institute for Experimental Medical Research, Oslo University Hospital , Oslo , Norway.
authors.forename: Geir
authors.initials: G
authors.lastname: Christensen
authors.affiliation: e Division of Intensive Care Medicine, Department of Anesthesiology, Intensive Care and Pain Medicine , University of Helsinki and Helsinki University Hospital , Helsinki , Finland.|h Department of Intensive Care Medicine , Bern University Hospital, University of Bern , Bern , Switzerland.
authors.forename: Ville
authors.initials: V
authors.lastname: Pettilä
authors.affiliation: a Division of Medicine , Akershus University Hospital , Lørenskog , Norway.|b Center for Heart Failure Research, University of Oslo , Oslo , Norway.
authors.forename: Torbjørn
authors.initials: T
authors.lastname: Omland
authors.affiliation: a Division of Medicine , Akershus University Hospital , Lørenskog , Norway.|b Center for Heart Failure Research, University of Oslo , Oslo , Norway.
authors.forename: Helge
authors.initials: H
authors.lastname: Røsjø
mesh_terms: D000208:Acute Disease; D000368:Aged; D015415:Biomarkers / Q000097:blood*; D053378:Chromogranin B / Q000097:blood*; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007362:Intensive Care Units / Q000706:statistics & numerical data; D008297:Male; D008875:Middle Aged; D020097:Natriuretic Peptide, Brain / Q000097:blood; D011379:Prognosis; D016016:Proportional Hazards Models; D012131:Respiratory Insufficiency / Q000097:blood* / Q000175:diagnosis / Q000401:mortality; D015996:Survival Rate
chemical_list: D015415:Biomarkers; D053378:Chromogranin B; D020097:Natriuretic Peptide, Brain
keywords: Chromogranin B; acute respiratory failure; biomarker; prognosis