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Bronchial Thermoplasty: A Novel Therapeutic Approach to Severe Asthma
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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
Summary
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.
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