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Stable-State Midrange Proadrenomedullin Is Associated With Severe Exacerbations in COPD

Emanuel Citgez1, Maaike Zuur-Telgen2, Job van der Palen3

  • 1Department of Pulmonary Medicine, Medisch Spectrum Twente, Enschede, The Netherlands; Department of Research Methodology, Measurement, and Data Analysis, University of Twente, Enschede, The Netherlands.

Chest
|February 24, 2018
PubMed
Abstract

Insights

Elevated midrange proadrenomedullin (MR-proADM) in stable COPD patients predicts a higher risk of severe acute exacerbations (AECOPDs). However, stable MR-proADM levels do not significantly predict community-acquired pneumonia (CAP) in this population.

Area of Science:

  • Pulmonary Medicine
  • Biomarkers
  • Clinical Research

Background:

  • Midrange proadrenomedullin (MR-proADM) is linked to adverse outcomes in various diseases.
  • Its association with severe acute exacerbations of COPD (AECOPDs) and community-acquired pneumonia (CAP) in stable COPD patients remains uninvestigated.

Purpose of the Study:

  • To investigate the association between stable-state MR-proADM levels and the risk of severe AECOPD and CAP in patients with COPD.

Main Methods:

  • Data from 1,285 COPD patients from the COMIC and PROMISE-COPD cohorts were pooled.
  • Time to first severe AECOPD was compared between patients with high (≥ 0.87 nmol/L) and low (< 0.87 nmol/L) stable-state MR-proADM levels.
  • Time to first CAP was analyzed using COMIC data (n=795).

Main Results:

  • High stable-state MR-proADM levels were significantly associated with a higher risk of severe AECOPD (corrected HR, 1.30; 95% CI, 1.01-1.68).
  • While high MR-proADM showed a univariate association with CAP risk (HR, 1.93; 95% CI, 1.24-3.01), this was not significant after adjusting for covariates (corrected HR, 1.10; 95% CI, 0.68-1.80).

Conclusions:

  • Stable-state high MR-proADM levels in COPD patients are a significant predictor of severe AECOPD.
  • Stable-state MR-proADM levels do not appear to be a significant predictor of CAP in COPD patients.
Keywords:
COPDbiomarkerspneumonia

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