Mathilde Fraty1,2, Gilberto Velho3, Elise Gand4, Fréderic Fumeron3,5, Stéphanie Ragot6,7,8, Philippe Sosner9,10,11, Kamel Mohammedi12, Barnabas Gellen13, Pierre-Jean Saulnier6,7,8, Jean-Michel Halimi14,15, David Montaigne16,17, Grégory Ducrocq5,18, Michaela Rehman6,19, Michel Marre3,5,20, Ronan Roussel3,5,20, Samy Hadjadj21,22,23,24. 1. Centre d'Investigation Clinique, CHU de Poitiers, Poitiers, France. Mathilde.fraty@gmail.com. 2. Service d'Endocrinologie-Diabétologie, CHU de Poitiers, 2 rue de la Milétrie, 86021, Poitiers, France. Mathilde.fraty@gmail.com. 3. Centre de Recherche des Cordeliers, Inserm UMR_S 1138, Paris, France. 4. Pole DUNE (Digestif, Urologie, Néphrologie, Endocrinologie), CHU de Poitiers, Poitiers, France. 5. UFR de Médecine, Université Paris Diderot, Sorbonne Paris Cité, Paris, France. 6. Centre d'Investigation Clinique, CHU de Poitiers, Poitiers, France. 7. UFR de Médecine et Pharmacie, Université de Poitiers, Poitiers, France. 8. CIC 1402, Inserm Poitiers, Poitiers, France. 9. Centre médico-sportif MON STADE, Paris, France. 10. Centre de Diagnostic et de Thérapeutique, AP-HP Hôpital Universitaire Hôtel-Dieu, Paris, France. 11. Laboratoire MOVE (EA 6314), Faculté des Sciences du Sport, Université de Poitiers, Poitiers, France. 12. Service Endocrinologie, Diabétologie, Nutrition, Hôpital Haut Lévêque, CHU de Bordeaux, Pessac, France. 13. Service de Cardiologie, Polyclinique de Poitiers, Poitiers, France. 14. Service Néphrologie, Dialyse et Transplantation, CHU de Tours, Tours, France. 15. Inserm CIC0202, Tours, France. 16. Clinique de Physiologie et Département d'Échocardiographie, CHRU Lille, Lille, France. 17. Inserm U1011, EGID, Institut Pasteur de Lille, Université de Lille, Lille, France. 18. Service de Cardiologie, AP-HP, Hôpital Bichat Claude Bernard, Paris, France. 19. Service de Cardiologie, CHU de Poitiers, Poitiers, France. 20. Service de Diabétologie, Endocrinologie et Nutrition, DHU FIRE, AP-HP, Hôpital Bichat Claude Bernard, Paris, France. 21. Centre d'Investigation Clinique, CHU de Poitiers, Poitiers, France. samy.hadjadj@gmail.com. 22. Service d'Endocrinologie-Diabétologie, CHU de Poitiers, 2 rue de la Milétrie, 86021, Poitiers, France. samy.hadjadj@gmail.com. 23. UFR de Médecine et Pharmacie, Université de Poitiers, Poitiers, France. samy.hadjadj@gmail.com. 24. CIC 1402, Inserm Poitiers, Poitiers, France. samy.hadjadj@gmail.com.
Abstract
AIMS/HYPOTHESIS: N-terminal pro-B-type natriuretic peptide (NT-proBNP) is the gold standard prognostic biomarker for diagnosis and occurrence of heart failure. Here, we compared its prognostic value for the occurrence of congestive heart failure with that of plasma mid-region pro-adrenomedullin (MR-proADM), a surrogate for adrenomedullin, a vasoactive peptide with vasodilator and natriuretic properties, in people with type 2 diabetes. METHODS: Plasma MR-proADM concentration was measured in baseline samples of a hospital-based cohort of consecutively recruited participants with type 2 diabetes. Our primary endpoint was heart failure requiring hospitalisation. RESULTS: We included 1438 participants (age 65 ± 11 years; 604 women and 834 men). Hospitalisation for heart failure occurred during follow-up (median 64 months) in 206 participants; the incidence rate of heart failure was 2.5 (95% CI 2.2, 2.9) per 100 person-years. Plasma concentrations of MR-proADM and NT-proBNP were significantly associated with heart failure in a Cox multivariable analysis model when adjusted for age, diabetes duration, history of coronary heart disease, proteinuria and baseline eGFR (adjHR [95%CI] 1.83 [1.51, 2.21] and 2.20 [1.86, 2.61], respectively, per 1 SD log10 increment, both p < 0.001). MR-proADM contributed significant supplementary information to the prognosis of heart failure when we considered the clinical risk factors (integrated discrimination improvement [IDI, mean ± SEM] 0.021 ± 0.007, p = 0.001) (Table 3). Inclusion of NT-proBNP in the multivariable model including MR-proADM contributed significant complementary information on prediction of heart failure (IDI [mean ± SEM] 0.028 ± 0.008, p < 0.001). By contrast, MR-proADM did not contribute supplementary information on prediction of heart failure in a model including NT-proBNP (IDI [mean ± SEM] 0.003 ± 0.003, p = 0.27), with similar results for heart failure with reduced ejection fraction and preserved ejection fraction. CONCLUSIONS/ INTERPRETATION: MR-proADM is a prognostic biomarker for heart failure in people with type 2 diabetes but gives no significant complementary information on prediction of heart failure compared with NT-proBNP.
AIMS/HYPOTHESIS: N-terminal pro-B-type natriuretic peptide (NT-proBNP) is the gold standard prognostic biomarker for diagnosis and occurrence of heart failure. Here, we compared its prognostic value for the occurrence of congestive heart failure with that of plasma mid-region pro-adrenomedullin (MR-proADM), a surrogate for adrenomedullin, a vasoactive peptide with vasodilator and natriuretic properties, in people with type 2 diabetes. METHODS: Plasma MR-proADM concentration was measured in baseline samples of a hospital-based cohort of consecutively recruited participants with type 2 diabetes. Our primary endpoint was heart failure requiring hospitalisation. RESULTS: We included 1438 participants (age 65 ± 11 years; 604 women and 834 men). Hospitalisation for heart failure occurred during follow-up (median 64 months) in 206 participants; the incidence rate of heart failure was 2.5 (95% CI 2.2, 2.9) per 100 person-years. Plasma concentrations of MR-proADM and NT-proBNP were significantly associated with heart failure in a Cox multivariable analysis model when adjusted for age, diabetes duration, history of coronary heart disease, proteinuria and baseline eGFR (adjHR [95%CI] 1.83 [1.51, 2.21] and 2.20 [1.86, 2.61], respectively, per 1 SD log10 increment, both p < 0.001). MR-proADM contributed significant supplementary information to the prognosis of heart failure when we considered the clinical risk factors (integrated discrimination improvement [IDI, mean ± SEM] 0.021 ± 0.007, p = 0.001) (Table 3). Inclusion of NT-proBNP in the multivariable model including MR-proADM contributed significant complementary information on prediction of heart failure (IDI [mean ± SEM] 0.028 ± 0.008, p < 0.001). By contrast, MR-proADM did not contribute supplementary information on prediction of heart failure in a model including NT-proBNP (IDI [mean ± SEM] 0.003 ± 0.003, p = 0.27), with similar results for heart failure with reduced ejection fraction and preserved ejection fraction. CONCLUSIONS/ INTERPRETATION:MR-proADM is a prognostic biomarker for heart failure in people with type 2 diabetes but gives no significant complementary information on prediction of heart failure compared with NT-proBNP.
Authors: Anne Funke-Kaiser; Aki S Havulinna; Tanja Zeller; Sebastian Appelbaum; Pekka Jousilahti; Erkki Vartiainen; Stefan Blankenberg; Karsten Sydow; Veikko Salomaa Journal: Ann Med Date: 2014-02-10 Impact factor: 4.709
Authors: Amir Razaghizad; Emily Oulousian; Varinder Kaur Randhawa; João Pedro Ferreira; James M Brophy; Stephen J Greene; Julian Guida; G Michael Felker; Marat Fudim; Michael Tsoukas; Tricia M Peters; Thomas A Mavrakanas; Nadia Giannetti; Justin Ezekowitz; Abhinav Sharma Journal: J Am Heart Assoc Date: 2022-05-16 Impact factor: 6.106