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[High levels of atrial natriuretic peptide and copeptin and mortality risk]

Corsino Rey1, Clara García-Cendón2, Pablo Martínez-Camblor3

  • 1Unidad de Cuidados Intensivos Pediátricos, Hospital Universitario Central de Asturias, Oviedo, Asturias, España; Universidad de Oviedo, Oviedo, Asturias, España; Red SAMID II, Instituto de Salud Carlos III, Madrid, España.

Anales De Pediatria (Barcelona, Spain : 2003)
|March 19, 2016
PubMed

Insights

High levels of mid-regional pro-atrial natriuretic peptide (MR-proANP), copeptin, and procalcitonin (PCT) indicate increased mortality risk in critically ill children. MR-proANP showed a stronger association with organ failure than copeptin.

Area of Science:

  • Biomarkers in critical care medicine
  • Pediatric critical illness research
  • Prognostic indicators in intensive care

Background:

  • Biomarkers are crucial for assessing prognosis in critically ill children.
  • Mid-regional pro-atrial natriuretic peptide (MR-proANP), copeptin, and procalcitonin (PCT) are potential indicators of critical illness severity.
  • Understanding the association of these biomarkers with mortality risk is vital for clinical decision-making.

Purpose of the Study:

  • To investigate the association between elevated plasma concentrations of MR-proANP, copeptin, and PCT and the risk of mortality in critically ill children.
  • To compare the predictive value of these biomarkers in relation to mortality risk and organ failure.
  • To evaluate MR-proANP, copeptin, and PCT as prognostic tools in pediatric intensive care.

Main Methods:

  • A prospective observational study was conducted on 254 critically ill children.
  • Plasma concentrations of MR-proANP, copeptin, and PCT were measured.
  • Children were stratified into high (Group A) and low (Group B) mortality risk groups, and by the number of failing organs (Group 1: >1 organ, Group 2: <2 organs).

Main Results:

  • Significantly higher median plasma levels of MR-proANP, copeptin, and PCT were observed in the high mortality risk group (Group A) compared to the low mortality risk group (Group B) (P<.001 for all).
  • The area under the curve (AUC) for differentiating mortality risk was highest for PCT (0.842), followed by MR-proANP (0.764) and copeptin (0.735).
  • MR-proANP demonstrated a statistically significant higher AUC (0.837) than copeptin (0.735) in differentiating between patients with failure of more than 1 organ versus less than 2 organs (P=.01).

Conclusions:

  • Elevated plasma concentrations of MR-proANP, copeptin, and PCT are associated with increased mortality risk in critically ill children.
  • PCT and MR-proANP show strong potential as prognostic biomarkers in this population.
  • MR-proANP exhibits a stronger association with the extent of organ failure compared to copeptin.
Abstract

Keywords:
Atrial natriuretic peptideCopeptinCopeptinaCritically ill childrenFallo de órganosMortality riskNiños críticamente enfermosOrgan failureProcalcitoninProcalcitoninaPrognosisPronósticoPéptido natriurético auricularRiesgo de mortalidad

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