The influence of diabetes mellitus on midregional proadrenomedullin concentrations and prognostic value in heart failure outpatients

TY - JOUR

T1 - The influence of diabetes mellitus on midregional proadrenomedullin concentrations and prognostic value in heart failure outpatients

AU - Holmager, Pernille

AU - Schou, Morten

AU - Egstrup, Michael

AU - Gustafsson, Ida

AU - Goetze, Jens Peter

AU - Gustafsson, Finn

AU - Klausen, Tobias Wirenfeldt

AU - Faber, Jens

AU - Kistorp, Caroline

N1 - Copyright © 2015 Elsevier Inc. All rights reserved.

PY - 2015/3/1

Y1 - 2015/3/1

N2 - Background Diabetes mellitus (DM) is associated with an adverse outcome in heart failure (HF). Increased concentrations of midregional proadrenomedullin (MR-proADM) have been associated with DM and are predictors of mortality in HF patients. The aim of this study was to elucidate the impact of DM on MR-proADM concentrations and the prognostic value regarding all-cause mortality and hospitalization among HF patients. Methods and Results We included 366 patients from an HF clinic; 69 (19%) had a history of DM and 40 (11%) had newly diagnosed DM (HbA1c ≥48 mmol/mol). The median MR-proADM concentration was unaffected by DM status (P =.20) but increased in HF patients with impaired renal function (P <.001). During a median follow-up of 55 months, 189 died, and 292 either died or were hospitalized. After adjustment for clinically relevant parameters, MR-proADM was associated with all-cause mortality (hazard ratio [HR] 1.3, 95% confidence interval [CI] 1.1-1.4; P =.01) and the combined end point of death and hospitalization (HR 1.2, 95% CI 1.1-1.4; P =.02) per 1 SD increment of ln-transformed variable. No interaction between DM and MR-proADM was found regarding mortality or hospitalization. Conclusions Diabetes status had no impact on MR-proADM concentrations or in the predictive ability of MR-proADM in HF patients.

AB - Background Diabetes mellitus (DM) is associated with an adverse outcome in heart failure (HF). Increased concentrations of midregional proadrenomedullin (MR-proADM) have been associated with DM and are predictors of mortality in HF patients. The aim of this study was to elucidate the impact of DM on MR-proADM concentrations and the prognostic value regarding all-cause mortality and hospitalization among HF patients. Methods and Results We included 366 patients from an HF clinic; 69 (19%) had a history of DM and 40 (11%) had newly diagnosed DM (HbA1c ≥48 mmol/mol). The median MR-proADM concentration was unaffected by DM status (P =.20) but increased in HF patients with impaired renal function (P <.001). During a median follow-up of 55 months, 189 died, and 292 either died or were hospitalized. After adjustment for clinically relevant parameters, MR-proADM was associated with all-cause mortality (hazard ratio [HR] 1.3, 95% confidence interval [CI] 1.1-1.4; P =.01) and the combined end point of death and hospitalization (HR 1.2, 95% CI 1.1-1.4; P =.02) per 1 SD increment of ln-transformed variable. No interaction between DM and MR-proADM was found regarding mortality or hospitalization. Conclusions Diabetes status had no impact on MR-proADM concentrations or in the predictive ability of MR-proADM in HF patients.

U2 - 10.1016/j.cardfail.2014.12.007

DO - 10.1016/j.cardfail.2014.12.007

M3 - Journal article

C2 - 25528198

SN - 1071-9164

VL - 21

SP - 250

EP - 257

JO - Journal of Cardiac Failure

JF - Journal of Cardiac Failure

IS - 3

ER -