Pro‐adrenomedullin associates with congestion in acute heart failure patients

Autor: Benedikt N. Beer, Saman Keshtkaran, Caroline Kellner, Lisa Besch, Jonas Sundermeyer, Angela Dettling, Paulus Kirchhof, Stefan Blankenberg, Christina Magnussen, Benedikt Schrage
Jazyk: angličtina
Rok vydání: 2024
Předmět:
Zdroj: ESC Heart Failure, Vol 11, Iss 6, Pp 3598-3606 (2024)
Druh dokumentu: article
ISSN: 2055-5822
DOI: 10.1002/ehf2.15007
Popis: Abstract Aim Congestion is a major determinant of outcomes in acute heart failure. Its assessment is complex, making sufficient decongestive therapy a challenge. Residual congestion is frequent at discharge, increasing the risk of re‐hospitalization and death. Mid‐regional pro‐adrenomedullin mirrors vascular integrity and may therefore be an objective marker to quantify congestion and to guide decongestive therapies in patients with acute heart failure. Methods and results Observational, prospective, single‐centre study in unselected patients presenting with acute heart failure. This study aimed to assess adrenomedullin's association with congestion and clinical outcomes: in‐hospital death, post‐discharge mortality and in‐hospital worsening heart failure according to RELAX‐AHF‐2 trial criteria. Pro‐adrenomedullin was quantified at baseline and at discharge. Congestion was assessed applying clinical scores. Cox and logistic regression models with adjustment for clinical features were fitted. N = 233, median age 77 years (IQR 67, 83), 148 male (63.5%). Median pro‐adrenomedullin 2.0 nmol/L (IQR 1.4, 2.9). Eight patients (3.5%) died in hospital and 100 (44.1%) experienced in‐hospital worsening heart failure. After discharge, 60 patients (36.6%) died over a median follow‐up of 1.92 years (95% CI: 1.76, 2.46). Pro‐adrenomedullin concentrations (logarithmized) were significantly associated with congestion, both at enrolment (β = 0.36 and 0.81 depending on score, each P
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