Midregional proadrenomedullin and its change predicts recurrent major coronary events and heart failure in stable coronary heart disease patients: The LIPID study

Funke-Kaiser, Anne, Mann, Kristy, Colquhoun, David, Zeller, Tanja, Hunt, David, Simes, John, Sullivan, David, Sydow, Karsten, West, Malcolm, White, Harvey, Blankenberg, Stefan and Tonkin, Andrew M. (2014) Midregional proadrenomedullin and its change predicts recurrent major coronary events and heart failure in stable coronary heart disease patients: The LIPID study. International Journal of Cardiology, 172 2: 411-418. doi:10.1016/j.ijcard.2014.01.064


Author Funke-Kaiser, Anne
Mann, Kristy
Colquhoun, David
Zeller, Tanja
Hunt, David
Simes, John
Sullivan, David
Sydow, Karsten
West, Malcolm
White, Harvey
Blankenberg, Stefan
Tonkin, Andrew M.
Title Midregional proadrenomedullin and its change predicts recurrent major coronary events and heart failure in stable coronary heart disease patients: The LIPID study
Journal name International Journal of Cardiology   Check publisher's open access policy
ISSN 0167-5273
1874-1754
Publication date 2014-03
Year available 2014
Sub-type Article (original research)
DOI 10.1016/j.ijcard.2014.01.064
Open Access Status
Volume 172
Issue 2
Start page 411
End page 418
Total pages 8
Place of publication Shannon, County Clare Ireland
Publisher Elsevier Ireland
Collection year 2015
Language eng
Formatted abstract
Background
Biomarkers may contribute to risk stratification in coronary heart disease (CHD). We examined whether plasma midregional proadrenomedullin (MR-proADM) concentration at baseline and its change over one year predicts long-term outcomes in stable CHD patients.

Methods
The LIPID study randomised patients 3–36 months after an acute coronary syndrome with total cholesterol 4.0–7.0 mmol/L (155–271 mg/dL), to placebo or pravastatin 40 mg. Follow-up was 6.0 years. MR-proADM plasma concentrations at baseline and one year later were determined in 7863 and 6658 patients, respectively. These were categorised into quartiles to perform Cox regression analysis, adjusting for baseline parameters.

Results
Baseline MR-proADM concentrations predicted major CHD events (non-fatal myocardial infarction or CHD death; hazard ratio (HR) 1.52, 1.26–1.84 for Q4–Q1), CHD death (HR 2.21, 1.67–2.92), heart failure (HR 2.30, 1.78–2.97) and all-cause mortality (HR 1.82, 1.49–2.23). Associations were still significant after adjustment for baseline B-type natriuretic peptide (BNP) concentration. Increase in MR-proADM after one year was associated with increased risk of subsequent CHD events (HR 1.34, 1.08–1.66), non-fatal myocardial infarction (HR 1.50, 1.12–2.03), heart failure (HR 1.78, 1.37–2.30) and all-cause mortality (HR 1.31, 1.04–1.64). Associations with heart failure and all-cause mortality remained significant after adjusting for baseline and change in BNP concentration. Change in MR-proADM moderately improved risk reclassification for major CHD events (net reclassification improvement (NRI) 3.48%) but strongly improved risk reclassification for heart failure (NRI 5.60%).

Conclusions
Baseline and change in MR-proADM concentrations over one year are associated with risk of major clinical events, even after adjustment for BNP concentrations.
Keyword Midregional proadrenomedullin
Biomarker
Risk factors
Coronary heart disease
Heart failure
Q-Index Code C1
Q-Index Status Confirmed Code
Institutional Status UQ

Document type: Journal Article
Sub-type: Article (original research)
Collections: Official 2015 Collection
School of Medicine Publications
 
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