Mid-Regional Pro-Adrenomedullin Is Associated with Adverse Cardiovascular Outcomes After Cardiac Surgery

Area of Science:

• Cardiology
• Biomarkers
• Personalized Medicine

Background:

• Risk stratification is vital for personalized medicine in cardiovascular interventions, especially for aging populations.
• Biomarker-based approaches are increasingly important for predicting outcomes.
• Mid-regional pro-adrenomedullin (MR-proADM) is an accessible biomarker reflecting cardiac function and fibrosis.

Purpose of the Study:

• To investigate the prognostic value of MR-proADM in patients undergoing elective cardiac surgery.
• To assess the association between MR-proADM levels and adverse cardiovascular events.

Main Methods:

• Prospective enrollment of 500 patients undergoing elective cardiac bypass and/or valve surgery (May 2013 - August 2018).
• Primary endpoint: composite of hospitalization for heart failure (HHF) or cardiovascular (CV) mortality over 5 years.
• Patients stratified into risk groups based on MR-proADM levels (Low, Intermediate, High).

Main Results:

• High MR-proADM levels significantly correlated with increased 5-year HHF/CV mortality rates (Low Risk 8.6% vs. High Risk 37.7%, p < 0.001).
• MR-proADM demonstrated an independent association with HHF/CV mortality (adjusted HR 3.43, p < 0.001).

Conclusions:

• MR-proADM is a strong, independent predictor of HHF/CV mortality post-elective cardiac surgery.
• Preoperative MR-proADM assessment can aid in identifying patients at risk for adverse events and re-hospitalization.
• Standardized MR-proADM evaluation supports personalized patient management and risk stratification.