Biologically active adrenomedullin as a marker for residual congestion and early rehospitalization in patients hospitalized for acute heart failure: Data from STRONG-HF

被引：12

作者：

Voordes, Geert ^{[1
]}

Davison, Beth ^{[2
,3
,4
,5
,6
,7
]}

Biegus, Jan ^{[8
]}

Edwards, Christopher ^{[6
]}

Damman, Kevin ^{[1
]}

ter Maaten, Jozine ^{[1
]}

Mebazaa, Alexandre ^{[2
,3
,4
,5
]}

Takagi, Koji ^{[6
]}

Adamo, Marianna ^{[9
,10
]}

Ambrosy, Andrew P. ^{[11
,12
]}

Arrigo, Mattia ^{[13
]}

Barros, Marianela ^{[6
]}

Celutkiene, Jelena ^{[14
]}

Cerlinskaite-Bajore, Kamile ^{[14
]}

Chioncel, Ovidiu ^{[15
]}

Cohen-Solal, Alain ^{[16
]}

Damasceno, Albertino ^{[17
]}

Deniau, Benjamin ^{[2
,3
,4
,5
]}

Diaz, Rafael ^{[18
]}

Filippatos, Gerasimos ^{[19
]}

Gayat, Etienne ^{[2
,3
,4
,5
]}

Kimmoun, Antoine ^{[20
,21
,22
]}

Lam, Carolyn S. P. ^{[23
,24
,25
,26
]}

Metra, Marco ^{[9
,10
]}

Novosadova, Maria ^{[6
]}

Pagnesi, Matteo ^{[9
,10
]}

Pang, Peter ^{[27
]}

Ponikowski, Piotr ^{[8
]}

Saidu, Hadiza ^{[28
]}

Sliwa, Karen ^{[29
]}

Tomasoni, Daniela ^{[9
,10
]}

Cotter, Gad ^{[2
,3
,4
,5
,6
,7
]}

Voors, Adriaan A. ^{[1
,30
]}

机构：

[1] Univ Groningen, Univ Med Ctr Groningen, Dept Cardiol, Groningen, Netherlands

[2] Univ Paris Cite, INSERM UMR-S 942 MASCOT, Paris, France

[3] St Louis Hosp, Dept Anesthesiol, Paris, France

[4] St Louis Hosp, Crit Care & Burn Unit, Paris, France

[5] Lariboisiere Hosp, FHU PROMICE, DMU Parabol, AP HP Nord, Paris, France

[6] Momentum Res, Durham, NC USA

[7] Heart Initiat, Durham, NC USA

[8] Wroclaw Med Univ, Inst Heart Dis, Wroclaw, Poland

[9] ASST Spedali Civili, Cardiol, Brescia, Italy

[10] Univ Brescia, Dept Med & Surg Specialties, Radiol Sci, Publ Hlth, Brescia, Italy

[11] Kaiser Permanente San Francisco Med Ctr, Dept Cardiol, San Francisco, CA USA

[12] Kaiser Permanente Northern Calif, Div Res, Oakland, CA USA

[13] Stadtspital Zurich, Dept Internal Med, Zurich, Switzerland

[14] Vilnius Univ, Inst Clin Med, Fac Med, Clin Cardiac & Vasc Dis, Vilnius, Lithuania

[15] Univ Med & Pharm Carol Davila, Emergency Inst Cardiovasc Dis Prof CC Iliescu, Bucharest, Romania

[16] Lariboisiere Univ Hosp, Dept Cardiol, APHP Nord, Paris, France

[17] Eduardo Mondlane Univ, Fac Med, Maputo, Mozambique

[18] Inst Cardiovasc Rosario, Estudios Cardiol Latinoamer, Rosario, Argentina

[19] Natl & Kapodistrian Univ Athens, Attikon Univ Hosp, Sch Med, Athens, Greece

[20] Univ Lorraine, Nancy, France

[21] INSERM, Defaillance Circulatoire Aigue & Chron, Vandoeuvre Les Nancy, France

[22] CHRU Nancy, Serv Med Intens & Reanimat Brabois, Vandoeuvre Les Nancy, France

[23] Natl Heart Ctr Singapore, Singapore, Singapore

[24] Duke Natl Univ Singapore, Singapore, Singapore

[25] Baim Inst Clin Res, Boston, MA USA

[26] Univ Med Ctr Groningen, Groningen, Netherlands

[27] Indiana Univ Sch Med, Dept Emergency Med, Indianapolis, IN USA

[28] Bayero Univ Kano, Murtala Muhammed Specialist Hosp, Kano, Nigeria

[29] Univ Cape Town, Groote Schuur Hosp, Div Cardiol, Dept Med, Cape Town, South Africa

[30] Univ Med Ctr Groningen, Dept Cardiol, Hanzepl 1,POB 30001,Groningen HPC AB 31, NL-9700 RB Groningen, Netherlands

来源：

EUROPEAN JOURNAL OF HEART FAILURE | 2024年 / 26卷 / 07期

关键词：

Biologically active adrenomedullin; Acute heart failure; Residual congestion; Biomarker; STRONG-HF; OPERATING CHARACTERISTIC CURVES; UNITED-STATES; AREAS;

D O I：

10.1002/ejhf.3336

中图分类号：

R5 [内科学];

学科分类号：

1002 ; 100201 ;

摘要：

Aims Biologically active adrenomedullin (bio-ADM) is a promising marker of residual congestion. The STRONG-HF trial showed that high-intensity care (HIC) of guideline-directed medical therapy (GDMT) improved congestion and clinical outcomes in heart failure (HF) patients. The association between bio-ADM, decongestion, outcomes and the effect size of HIC of GDMT remains to be elucidated. Methods and results We measured plasma bio-ADM concentrations in 1005 patients within 2 days prior to anticipated discharge (baseline) and 90 days later. Bio-ADM correlated with most signs of congestion, with the exception of rales. Changes in bio-ADM were strongly correlated with change in congestion status from baseline to day 90 (gamma -0.24; p = 0.0001). Patients in the highest tertile of baseline bio-ADM concentrations were at greater risk than patients in the lowest tertile for the primary outcome of 180-day all-cause mortality or HF rehospitalization (hazard ratio [HR] 2.14, 95% confidence interval [CI] 1.42-3.22) and 180-day HF rehospitalization (HR 2.33, 95% CI 1.38-3.94). Areas under the receiver-operating characteristic curves were 0.5977 (95% CI 0.5561-0.6393), 0.5800 (95% CI 0.5356-0.6243), and 0.6159 (95% CI 0.5711-0.6607) for bio-ADM, N-terminal pro-B-type natriuretic peptide (NT-proBNP) and their combination, respectively, suggesting that both bio-ADM and NT-proBNP provided similarly modest discrimination for this outcome. A trend towards better discrimination by combined bio-ADM and NT-proBNP than NT-proBNP alone was found (p = 0.059). HIC improved the primary outcome, irrespective of baseline bio-ADM concentration (interaction p = 0.37). In contrast to NT-proBNP, the 90-day change in bio-ADM did not differ significantly between HIC and usual care. Conclusions Bio-ADM is a marker of congestion and predicts congestion at 3 months after a HF hospitalization. Higher bio-ADM was modestly associated with a higher risk of death and early hospital readmission and may have added value when combined with NT-proBNP.

引用

页码：1480 / 1492

页数：13

共 28 条

[1] NT-proBNP and high intensity care for acute heart failure: the STRONG-HF trial [J].

Adamo, Marianna ;

Pagnesi, Matteo ;

Mebazaa, Alexandre ;

Davison, Beth ;

Edwards, Christopher ;

Tomasoni, Daniela ;

Arrigo, Mattia ;

Barros, Marianela ;

Biegus, Jan ;

Celutkiene, Jelena ;

Cerlinskaite-Bajore, Kamile ;

Chioncel, Ovidiu ;

Cohen-Solal, Alain ;

Damasceno, Albertino ;

Diaz, Rafael ;

Filippatos, Gerasimos ;

Gayat, Etienne ;

Kimmoun, Antoine ;

Lam, Carolyn S. P. ;

Novosadova, Maria ;

Pang, Peter S. ;

Ponikowski, Piotr ;

Saidu, Hadiza ;

Sliwa, Karen ;

Takagi, Koji ;

Ter Maaten, Jozine M. ;

Voors, Adriaan ;

Cotter, Gad ;

Metra, Marco .

EUROPEAN HEART JOURNAL, 2023, 44 (31) :2947-2962

[2] Adrenomedullin peptides and precursor levels in relation to haemodynamics and prognosis after heart transplantation [J].

Ahmed, Abdulla ;

Kania, Kriss ;

Abdul Rahim, Hebba ;

Ahmed, Salaheldin ;

Radegran, Goeran .

ESC HEART FAILURE, 2023, 10 (04) :2427-2437

[3] Estimating and comparing time-dependent areas under receiver operating characteristic curves for censored event times with competing risks [J].

Blanche, Paul ;

Dartigues, Jean-Francois ;

Jacqmin-Gadda, Helene .

STATISTICS IN MEDICINE, 2013, 32 (30) :5381-5397

[4] Congestion in heart failure: a contemporary look at physiology, diagnosis and treatment [J].

Boorsma, Eva M. ;

ter Maaten, Jozine M. ;

Damman, Kevin ;

Dinh, Wilfried ;

Gustafsson, Finn ;

Goldsmith, Steven ;

Burkhoff, Daniel ;

Zannad, Faiez ;

Udelson, James E. ;

Voors, Adriaan A. .

NATURE REVIEWS CARDIOLOGY, 2020, 17 (10) :641-655

[5] Enhanced Decongestive Therapy in Patients With Acute Heart Failure JACC Review Topic of the Week [J].

Cotter, Gad ;

Davison, Beth ;

Chioncel, Ovidiu .

JOURNAL OF THE AMERICAN COLLEGE OF CARDIOLOGY, 2024, 83 (13) :1243-1252

[6] Influence of socioeconomic factors on hospital readmissions for heart failure and acute myocardial infarction in patients 65 years and older: evidence from a systematic review [J].

Damiani, Gianfranco ;

Salvatori, Eleonora ;

Silvestrini, Giulia ;

Ivanova, Ivana ;

Bojovic, Luka ;

Iodice, Lanfranco ;

Ricciardi, Walter .

CLINICAL INTERVENTIONS IN AGING, 2015, 10 :237-245

[7] COMPARING THE AREAS UNDER 2 OR MORE CORRELATED RECEIVER OPERATING CHARACTERISTIC CURVES - A NONPARAMETRIC APPROACH [J].

DELONG, ER ;

DELONG, DM ;

CLARKEPEARSON, DI .

BIOMETRICS, 1988, 44 (03) :837-845

[8] Bioactive adrenomedullin for assessment of venous congestion in heart failure [J].

Egerstedt, Anna ;

Czuba, Tomasz ;

Bronton, Kevin ;

Lejonberg, Carl ;

Ruge, Thoralph ;

Wessman, Torgny ;

Radegran, Goran ;

Schulte, Janin ;

Hartmann, Oliver ;

Melander, Olle ;

Smith, J. Gustav .

ESC HEART FAILURE, 2022, 9 (05) :3543-3555

[9] Prognostic significance and clinical determinants of residual dyspnoea at discharge in acute heart failure: a single-centre, prospective observational study [J].

Garus, Mateusz ;

Jura, Maksym ;

Guzik, Mateusz ;

Zymlinski, Robert ;

Iwanek, Gracjan ;

Ponikowski, Piotr ;

Biegus, Jan .

BMJ OPEN, 2023, 13 (11)

[10] Integrative Assessment of Congestion in Heart Failure Throughout the Patient Journey [J].

Girerd, Nicolas ;

Seronde, Marie-France ;

Coiro, Stefano ;

Chouihed, Tahar ;

Bilbault, Pascal ;

Braun, Francois ;

Kenizou, David ;

Maillier, Bruno ;

Nazeyrollas, Pierre ;

Roul, Gerard ;

Fillieux, Ludivine ;

Abraham, William T. ;

Januzzi, James, Jr. ;

Sebbag, Laurent ;

Zannad, Faiez ;

Mebazaa, Alexandre ;

Rossignol, Patrick .

JACC-HEART FAILURE, 2018, 6 (04) :273-285

← 1 2 3 →