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Published on: January 28, 2020
Low serum corin levels predict end-organ damage in patients with hypertensive crisis
Burcu Genç Yavuz1, Özgür Söğüt2, Şahin Çolak1
1Department of Emergency Medicine, University of Health Sciences, Haydarpaşa Numune Training and Research Hospital, Istanbul, Turkey.
Insights
Low serum corin levels can help differentiate hypertensive emergency from hypertensive urgency. This biomarker may predict end-organ damage in hypertensive crisis patients.
Area of Science:
- Cardiology
- Nephrology
- Endocrinology
Background:
- Hypertensive crisis (HC) requires prompt differentiation between hypertensive urgency (HU) and hypertensive emergency (HE).
- Distinguishing HU from HE is crucial for appropriate patient management and preventing end-organ damage.
- Biomarkers that aid in this differentiation are of significant clinical interest.
Purpose of the Study:
- To evaluate the predictive value of serum corin levels in differentiating between HU and HE.
- To assess the association between serum corin levels and end-organ damage in patients with HC.
Main Methods:
- 120 HC patients and 55 healthy controls were enrolled.
- Serum corin levels, blood pressure (systolic, diastolic, MAP), and end-organ damage were assessed.
- Patients were classified as HE or HU based on end-organ damage presence.
Main Results:
- Serum corin levels were significantly lower in HC patients compared to controls.
- Serum corin levels were lower in HE patients than in HU patients (p<0.001).
- A serum corin cutoff of 45 pg/mL distinguished HE from HU with 98.3% sensitivity and 95% specificity.
Conclusions:
- Serum corin levels are implicated in blood pressure regulation and HC pathogenesis.
- Low serum corin levels may predict end-organ damage in HC.
- Serum corin can serve as a diagnostic guide for differentiating HE from HU.
Objective:
The study aimed to investigate the predictive power of serum corin levels for distinguishing between hypertensive urgency (HU) and hypertensive emergency (HE) in patients with hypertensive crisis (HC) admitted to the emergency department.
Methods:
A total of 120 consecutive consenting adult patients diagnosed with HC and 55 age- and sex-matched healthy controls were enrolled. Blood pressure measurements [(systolic, diastolic, and mean arterial pressure (MAP)] and the evidence of end-organ damage at the first admission were recorded. Patients with HC were classified as patients with HE or HU according to the presence or absence of acute end-organ damage. Serum corin levels were compared between the 2 groups.
Results:
The mean serum corin level was significantly lower in the HC group than in the control group; it was also lower in the HE group than in the HU group (p<0.001 for all). In the HE group, clinical features associated with end-organ damage included ST-elevation myocardial infarction (n=28, 46.7%), hemorrhagic stroke (n=11, 18.3%), ischemic stroke (n=11, 18.3%), and non-ST-elevation myocardial infarction (n=10, 16.7%). The receiving operator characteristic (ROC) analysis identified a serum corin cutoff value of 45 pg/mL for distinguishing patients with HE from patients with HU with 98.3% sensitivity and 95% specificity.
Conclusion:
Our findings suggest that serum corin levels play an important role in regulating blood pressure and are involved in the pathogenesis of HC. Low serum corin levels may predict end-organ damage and serve as a guide for diagnostic decision making in patients with HC.
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