Abstract 15899: Pro-Adrenomedullin (mr-proadm) Can Predict Short and Long Term Mortality in Stemi Patients
BACKGROUND: Midregional pro-Adrenomedulin (MR-proADM) appears to be a powerful predictor of adverse outcome after AMI when measured 3 to 5 days after symptoms onset.
OBJECTIVES: We sought to assess whether (MR-proADM) measured at admission would correlate with the outcome in ST-segment elevation myocardial infarction patient treated with primary PCI.
METHODS : We measured plasma MR-proADM in 283 consecutive STEMI patients (74.8% men, mean age 64.2 ± 15 years) immediately after the sheath insertion and before the primary PCI. We assessed the relation between MR-proADM and mortality (in-hospital and 1year of follow-up) and compared them to the prognostic value of troponin I (peak value) and the TIMI risk Score for STEMI patients.
RESULTS: All cause mortality was 4.5% at discharge and 7.3% at the end of the follow-up (365 days). The MR-proADM was increased in patients who died compared with survivors (median 1.27 nmol/l, IQR [0.99 to 3.16 nmol/l], vs. 0.53 nmol/l, range 0.39 to 0.68 nmol/l], p < 0.0001). The areas under the receiver-operating characteristic curve for long-term survival (one year) for MR-proADM, Troponin I (peak value in µg/l) and TIMI Risk Score were 0.79 (0.64-0.95) p<0.001, 0.58 (0.49-0.68) p=0.06, and 0.67 (0.55-0.79) p=0.01 respectively. Findings were similar for in-hospital mortality 0.77 (0.55-0.98) p=0.002 for MR-proADM.
CONCLUSIONS: Early measurement of MR-proADM during the acute phase of AMI is a powerful predictor of short and long term mortality in STEMI patients. The MR-proADM may represent a clinically useful marker of prognosis during AMI.
- © 2011 by American Heart Association, Inc.