MR-proADM as a Prognostic Marker in Patients With ST-Segment-Elevation Myocardial Infarction - DANAMI-3 (a Danish Study of Optimal Acute Treatment of Patients With STEMI) Substudy

Alexander C Falkentoft; Rasmus Rørth; Kasper Iversen; Dan E Høfsten; Henning Kelbæk; Lene Holmvang; Martin Frydland; Mikkel M Schoos; Steffen Helqvist; Anna Axelsson; Peter Clemmensen; Erik Jørgensen; Kari Saunamäki; Hans-Henrik Tilsted; Frants Pedersen; Christian Torp-Pedersen; Klaus F. Kofoed; Jens P. Goetze; Thomas Engstrøm; Lars Køber

doi:10.1161/JAHA.117.008123

MR-proADM as a Prognostic Marker in Patients With ST-Segment-Elevation Myocardial Infarction - DANAMI-3 (a Danish Study of Optimal Acute Treatment of Patients With STEMI) Substudy

Alexander C Falkentoft, Rasmus Rørth, Kasper Iversen, Dan E Høfsten, Henning Kelbæk, Lene Holmvang, Martin Frydland, Mikkel M Schoos, Steffen Helqvist, Anna Axelsson, Peter Clemmensen, Erik Jørgensen, Kari Saunamäki, Hans-Henrik Tilsted, Frants Pedersen, Christian Torp-Pedersen, Klaus F. Kofoed, Jens P. Goetze, Thomas Engstrøm, Lars Køber

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Abstract

Background--Midregional proadrenomedullin (MR-proADM) has demonstrated prognostic potential after myocardial infarction (MI). Yet, the prognostic value of MR-proADM at admission has not been examined in patients with ST-segment-elevation MI (STEMI). Methods and Results--The aim of this substudy, DANAMI-3 (The Danish Study of Optimal Acute Treatment of Patients with STsegment- elevation myocardial infarction), was to examine the associations of admission concentrations of MR-proADM with shortand long-term mortality and hospital admission for heart failure in patients with ST-segment-elevation myocardial infarction. Outcomes were assessed using Cox proportional hazard models and area under the curve using receiver operating characteristics. In total, 1122 patients were included. The median concentration of MR-proADM was 0.64 nmol/L (25th-75th percentiles, 0.53- 0.79). Within 30 days 23 patients (2.0%) died and during a 3-year follow-up 80 (7.1%) died and 38 (3.4%) were admitted for heart failure. A doubling of MR-proADM was, in adjusted models, associated with an increased risk of 30-day mortality (hazard ratio, 2.67; 95% confidence interval, 1.01-7.11; P=0.049), long-term mortality (hazard ratio, 3.23; 95% confidence interval, 1.97-5.29; P < 0.0001), and heart failure (hazard ratio, 2.71; 95% confidence interval, 1.32-5.58; P=0.007). For 30-day and 3-year mortality, the area under the curve for MR-proADM was 0.77 and 0.78, respectively. For 3-year mortality, area under the curve (0.84) of the adjusted model marginally changed (0.85; P=0.02) after addition of MR-proADM. Conclusions--Elevation of admission MR-proADM was associated with long-term mortality and heart failure, whereas the association with short-term mortality was borderline significant. MR-proADM may be a marker of prognosis after ST-segment- elevation myocardial infarction but does not seem to add substantial prognostic information to established clinical models. Clinical Trial Registration--URL: http:/www.ClinicalTrials.gov/. Unique identifiers: NCT01435408 and NCT01960933.

Original language	English
Article number	e008123
Journal	Journal of the American Heart Association
Volume	7
Issue number	11
Pages (from-to)	1-13
ISSN	2047-9980
DOIs	https://doi.org/10.1161/JAHA.117.008123
Publication status	Published - 1 Jun 2018

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MR-proADM as a Prognostic Marker in Patients With ST-Segment–Elevation Myocardial Infarction—DANAMI-3 (a Danish Study of Optimal Acute Treatment of Patients With STEMI) SubstudyFinal published version, 543 KBLicence: CC BY-NC

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Falkentoft, A. C., Rørth, R., Iversen, K., Høfsten, D. E., Kelbæk, H., Holmvang, L., Frydland, M., Schoos, M. M., Helqvist, S., Axelsson, A., Clemmensen, P., Jørgensen, E., Saunamäki, K., Tilsted, H-H., Pedersen, F., Torp-Pedersen, C., Kofoed, K. F., Goetze, J. P., Engstrøm, T., & Køber, L. (2018). MR-proADM as a Prognostic Marker in Patients With ST-Segment-Elevation Myocardial Infarction - DANAMI-3 (a Danish Study of Optimal Acute Treatment of Patients With STEMI) Substudy. Journal of the American Heart Association, 7(11), 1-13. [e008123]. https://doi.org/10.1161/JAHA.117.008123

MR-proADM as a Prognostic Marker in Patients With ST-Segment-Elevation Myocardial Infarction - DANAMI-3 (a Danish Study of Optimal Acute Treatment of Patients With STEMI) Substudy. / Falkentoft, Alexander C; Rørth, Rasmus; Iversen, Kasper et al.

In: Journal of the American Heart Association, Vol. 7, No. 11, e008123, 01.06.2018, p. 1-13.

Research output: Contribution to journal › Journal article › Research › peer-review

Falkentoft, AC, Rørth, R, Iversen, K , Høfsten, DE, Kelbæk, H, Holmvang, L, Frydland, M, Schoos, MM, Helqvist, S, Axelsson, A, Clemmensen, P, Jørgensen, E, Saunamäki, K, Tilsted, H-H, Pedersen, F, Torp-Pedersen, C, Kofoed, KF , Goetze, JP , Engstrøm, T & Køber, L 2018, 'MR-proADM as a Prognostic Marker in Patients With ST-Segment-Elevation Myocardial Infarction - DANAMI-3 (a Danish Study of Optimal Acute Treatment of Patients With STEMI) Substudy', Journal of the American Heart Association, vol. 7, no. 11, e008123, pp. 1-13. https://doi.org/10.1161/JAHA.117.008123

@article{886997a0a2ec4770935521c27ec2801f,

title = "MR-proADM as a Prognostic Marker in Patients With ST-Segment-Elevation Myocardial Infarction - DANAMI-3 (a Danish Study of Optimal Acute Treatment of Patients With STEMI) Substudy",

abstract = "Background--Midregional proadrenomedullin (MR-proADM) has demonstrated prognostic potential after myocardial infarction (MI). Yet, the prognostic value of MR-proADM at admission has not been examined in patients with ST-segment-elevation MI (STEMI). Methods and Results--The aim of this substudy, DANAMI-3 (The Danish Study of Optimal Acute Treatment of Patients with STsegment- elevation myocardial infarction), was to examine the associations of admission concentrations of MR-proADM with shortand long-term mortality and hospital admission for heart failure in patients with ST-segment-elevation myocardial infarction. Outcomes were assessed using Cox proportional hazard models and area under the curve using receiver operating characteristics. In total, 1122 patients were included. The median concentration of MR-proADM was 0.64 nmol/L (25th-75th percentiles, 0.53- 0.79). Within 30 days 23 patients (2.0%) died and during a 3-year follow-up 80 (7.1%) died and 38 (3.4%) were admitted for heart failure. A doubling of MR-proADM was, in adjusted models, associated with an increased risk of 30-day mortality (hazard ratio, 2.67; 95% confidence interval, 1.01-7.11; P=0.049), long-term mortality (hazard ratio, 3.23; 95% confidence interval, 1.97-5.29; P < 0.0001), and heart failure (hazard ratio, 2.71; 95% confidence interval, 1.32-5.58; P=0.007). For 30-day and 3-year mortality, the area under the curve for MR-proADM was 0.77 and 0.78, respectively. For 3-year mortality, area under the curve (0.84) of the adjusted model marginally changed (0.85; P=0.02) after addition of MR-proADM. Conclusions--Elevation of admission MR-proADM was associated with long-term mortality and heart failure, whereas the association with short-term mortality was borderline significant. MR-proADM may be a marker of prognosis after ST-segment- elevation myocardial infarction but does not seem to add substantial prognostic information to established clinical models. Clinical Trial Registration--URL: http:/www.ClinicalTrials.gov/. Unique identifiers: NCT01435408 and NCT01960933.",

author = "Falkentoft, {Alexander C} and Rasmus R{\o}rth and Kasper Iversen and H{\o}fsten, {Dan E} and Henning Kelb{\ae}k and Lene Holmvang and Martin Frydland and Schoos, {Mikkel M} and Steffen Helqvist and Anna Axelsson and Peter Clemmensen and Erik J{\o}rgensen and Kari Saunam{\"a}ki and Hans-Henrik Tilsted and Frants Pedersen and Christian Torp-Pedersen and Kofoed, {Klaus F.} and Goetze, {Jens P.} and Thomas Engstr{\o}m and Lars K{\o}ber",

year = "2018",

month = jun,

day = "1",

doi = "10.1161/JAHA.117.008123",

language = "English",

volume = "7",

pages = "1--13",

journal = "Journal of the American Heart Association",

issn = "2047-9980",

publisher = "Wiley-Blackwell",

number = "11",

}

TY - JOUR

T1 - MR-proADM as a Prognostic Marker in Patients With ST-Segment-Elevation Myocardial Infarction - DANAMI-3 (a Danish Study of Optimal Acute Treatment of Patients With STEMI) Substudy

AU - Falkentoft, Alexander C

AU - Rørth, Rasmus

AU - Iversen, Kasper

AU - Høfsten, Dan E

AU - Kelbæk, Henning

AU - Holmvang, Lene

AU - Frydland, Martin

AU - Schoos, Mikkel M

AU - Helqvist, Steffen

AU - Axelsson, Anna

AU - Clemmensen, Peter

AU - Jørgensen, Erik

AU - Saunamäki, Kari

AU - Tilsted, Hans-Henrik

AU - Pedersen, Frants

AU - Torp-Pedersen, Christian

AU - Kofoed, Klaus F.

AU - Goetze, Jens P.

AU - Engstrøm, Thomas

AU - Køber, Lars

PY - 2018/6/1

Y1 - 2018/6/1

N2 - Background--Midregional proadrenomedullin (MR-proADM) has demonstrated prognostic potential after myocardial infarction (MI). Yet, the prognostic value of MR-proADM at admission has not been examined in patients with ST-segment-elevation MI (STEMI). Methods and Results--The aim of this substudy, DANAMI-3 (The Danish Study of Optimal Acute Treatment of Patients with STsegment- elevation myocardial infarction), was to examine the associations of admission concentrations of MR-proADM with shortand long-term mortality and hospital admission for heart failure in patients with ST-segment-elevation myocardial infarction. Outcomes were assessed using Cox proportional hazard models and area under the curve using receiver operating characteristics. In total, 1122 patients were included. The median concentration of MR-proADM was 0.64 nmol/L (25th-75th percentiles, 0.53- 0.79). Within 30 days 23 patients (2.0%) died and during a 3-year follow-up 80 (7.1%) died and 38 (3.4%) were admitted for heart failure. A doubling of MR-proADM was, in adjusted models, associated with an increased risk of 30-day mortality (hazard ratio, 2.67; 95% confidence interval, 1.01-7.11; P=0.049), long-term mortality (hazard ratio, 3.23; 95% confidence interval, 1.97-5.29; P < 0.0001), and heart failure (hazard ratio, 2.71; 95% confidence interval, 1.32-5.58; P=0.007). For 30-day and 3-year mortality, the area under the curve for MR-proADM was 0.77 and 0.78, respectively. For 3-year mortality, area under the curve (0.84) of the adjusted model marginally changed (0.85; P=0.02) after addition of MR-proADM. Conclusions--Elevation of admission MR-proADM was associated with long-term mortality and heart failure, whereas the association with short-term mortality was borderline significant. MR-proADM may be a marker of prognosis after ST-segment- elevation myocardial infarction but does not seem to add substantial prognostic information to established clinical models. Clinical Trial Registration--URL: http:/www.ClinicalTrials.gov/. Unique identifiers: NCT01435408 and NCT01960933.

AB - Background--Midregional proadrenomedullin (MR-proADM) has demonstrated prognostic potential after myocardial infarction (MI). Yet, the prognostic value of MR-proADM at admission has not been examined in patients with ST-segment-elevation MI (STEMI). Methods and Results--The aim of this substudy, DANAMI-3 (The Danish Study of Optimal Acute Treatment of Patients with STsegment- elevation myocardial infarction), was to examine the associations of admission concentrations of MR-proADM with shortand long-term mortality and hospital admission for heart failure in patients with ST-segment-elevation myocardial infarction. Outcomes were assessed using Cox proportional hazard models and area under the curve using receiver operating characteristics. In total, 1122 patients were included. The median concentration of MR-proADM was 0.64 nmol/L (25th-75th percentiles, 0.53- 0.79). Within 30 days 23 patients (2.0%) died and during a 3-year follow-up 80 (7.1%) died and 38 (3.4%) were admitted for heart failure. A doubling of MR-proADM was, in adjusted models, associated with an increased risk of 30-day mortality (hazard ratio, 2.67; 95% confidence interval, 1.01-7.11; P=0.049), long-term mortality (hazard ratio, 3.23; 95% confidence interval, 1.97-5.29; P < 0.0001), and heart failure (hazard ratio, 2.71; 95% confidence interval, 1.32-5.58; P=0.007). For 30-day and 3-year mortality, the area under the curve for MR-proADM was 0.77 and 0.78, respectively. For 3-year mortality, area under the curve (0.84) of the adjusted model marginally changed (0.85; P=0.02) after addition of MR-proADM. Conclusions--Elevation of admission MR-proADM was associated with long-term mortality and heart failure, whereas the association with short-term mortality was borderline significant. MR-proADM may be a marker of prognosis after ST-segment- elevation myocardial infarction but does not seem to add substantial prognostic information to established clinical models. Clinical Trial Registration--URL: http:/www.ClinicalTrials.gov/. Unique identifiers: NCT01435408 and NCT01960933.

U2 - 10.1161/JAHA.117.008123

DO - 10.1161/JAHA.117.008123

M3 - Journal article

C2 - 29776961

SN - 2047-9980

VL - 7

SP - 1

EP - 13

JO - Journal of the American Heart Association

JF - Journal of the American Heart Association

IS - 11

M1 - e008123

ER -

MR-proADM as a Prognostic Marker in Patients With ST-Segment-Elevation Myocardial Infarction - DANAMI-3 (a Danish Study of Optimal Acute Treatment of Patients With STEMI) Substudy

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