Prognostic Value for Mortality of Plasma Bioactive Adrenomedullin in Patients with Pulmonary Arterial Hypertension: A Sub Analysis of the Biomarker Study in the COHARD-PH Registry
Abstract
:1. Introduction
2. Materials and Methods
2.1. Subjects’ Enrollment
2.2. Biomarker Procedures
2.3. Mortality Outcomes
2.4. Statistical Analysis
3. Results
3.1. Bio-ADM
3.2. Bio-ADM and Mortality
4. Discussion
The Study’s Limitations
- (1)
- A rather small number of subjects with I/H PAH were enrolled, leading to the need to confirm these data in a new multicentric prospective study with more patients from these groups.
- (2)
- The biomarkers’ results were obtained analyzing blood samples that were stored and frozen for a long period, and we cannot exclude the possibility that this could have affected the results. Consequently, it will be necessary to confirm the results of biomarker data obtained from this study and analyze fresh plasma samples in the future.
- (3)
- The use of medication with PAH-specific drugs was quite limited in our COHARD-PH registry, since not all PAH-specific drugs are available in Indonesia.
5. Conclusions
Author Contributions
Funding
Institutional Review Board Statement
Informed Consent Statement
Data Availability Statement
Acknowledgments
Conflicts of Interest
References
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Parameters | Control Group (n = 20) | ASD-PAH (n = 85) | I/H PAH (n = 15) | p Value |
---|---|---|---|---|
Age, years (mean ± SD) | 30.70 ± 7.63 | 36.45 ± 11.60 | 39.33 ± 10.80 | 0.049 |
Sex | ||||
Female, n(%) (n = 99 (82.5%) | 18 (90.0) | 69 (81.2) | 12 (80.0) | 0.623 |
Male, n(%) (n = 21 (17.5%) | 2 (10.0) | 16 (18.8) | 3 (20.0) | |
LV EF, % (mean ± SD) | 69.70 ± 6.63 | 71.52 ± 9.07 | NA | 0.313 |
TAPSE, mm (mean ± SD) | 27.80 ± 3.65 | 23.59 ± 5.89 | 17.50 ± 7.05 (n = 12) | <0.001 |
TV gradient, mmHg (mean ± SD) | 28.11 ± 9.40 | 84.90 ± 31.09 | 85.00 ± 18.38 (n = 2) | <0.001 |
Hemoglobin, g/dL (mean ± SD) | 12.84 ± 1.21 | 14.49 ± 2.30 | 13.93 ± 1.81 | 0.008 |
Hematocrit, % (mean ± SD) | 38.93 ± 3.03 | 43.68 ± 6.37 | 42.40 ± 4.77 | 0.005 |
NT-proBNP, pg/mL (mean ± SD) | 107.45 ± 95.39 (n = 13) | 2256.32 ± 3497.64 (n = 69) | 1566.36 ± 1143.37 (n = 14) | 0.063 |
mPAP, mmHg (mean ± SD) | 17.40 ± 2.21 | 56.93 ± 17.57 | 64.27 ± 17.13 | <0.001 |
PVR index, WU/m2 (mean ± SD) | 1.46 ± 0.75 | 16.31 ± 16.55 | 31.32 ± 10.89 | <0.001 |
mRAP, mmHg (mean ± SD) | 5.72 ± 3.34 (n = 18) | 11.83 ± 6.28 | 13.73 ± 7.74 | <0.001 |
SaO2 Aorta, % (mean ± SD) | 96.23 ± 1.72 | 88.97 ± 6.32 (n = 80) | 90.35 ± 6.39 | <0.001 |
Bio-ADM, pg/mL | Control Group (n = 20) | ASD-PAH (n = 85) | I/H PAH (n = 15) |
---|---|---|---|
Mean ± SD * | 6.33 ± 4.79 | 10.55 ± 12.82 | 17.65 ± 13.62 |
Median (IQR) | 5.15 (3.0–7.95) | 7.30 (4.10–13.50) | 15.50 (7.50–24.10) |
Parameters | Mortality (+) (n = 21) | Mortality (−) (n = 99) | p Value |
---|---|---|---|
Age, years (mean ± SD) | 34.43 ± 11.49 | 36.15 ± 11.13 | 0.261 |
Sex | |||
Female, n (%) | 21 (100) | 78 (78.8) | 0.023 |
Male, n (%) | 0 (0) | 21 (21.2) | |
LV ejection fraction, % (mean ± SD) | 68.08 ± 9.16 (n = 13) | 71.61 ± 8.54 (n = 91) | 0.085 |
TAPSE, mm (mean ± SD) | 21.10 ± 6.65 (n = 20) | 24.23 ± 6.05 (n = 96) | 0.020 |
TV gradient, mmHg (mean ± SD) | 76.58 ± 29.37 (n = 12) | 74.26 ± 36.58 (n = 92) | 0.417 |
Hemoglobin, g/dL (mean ± SD) | 13.18 ± 1.49 (n = 20) | 14.34 ± 2.26 | 0.014 |
Hematocrit, % (mean ± SD) | 40.51 ± 4.14 (n = 20) | 43.18 ± 6.23 | 0.035 |
NT-proBNP, pg/mL (mean ± SD) | 2180.45 ± 3148.9 (n = 18) | 1791.84 ± 3079.41 (n = 78) | 0.316 |
mPAP, mmHg (median, IQR) | 56.00 (45.00–67.00) | 50.50 (34.75–66.00) | 0.257 * |
PVR index, WU/m2 (median, IQR) | 15.30 (5.30–24.40) (n = 19) | 7.93 (2.76–25.08) (n = 98) | 0.185 * |
mRAP, mmHg (mean ± SD) | 13.52 ± 7.81 | 10.61 ± 6.16 (n = 96) | 0.032 |
SaO2 Aorta, % (mean ± SD) | 90.48 ± 6.10 (n = 19) | 90.32 ± 6.48 (n = 94) | 0.460 |
PAH, n (%) | 21 (100.0) | 79 (79.8) | 0.022 |
Diagnosis | |||
ASD without PH | 0 (0) | 20 (20.2) | <0.001 |
ASD-PAH | 13 (61.9) | 72 (72.7) | |
I/H-PAH | 8 (38.1) | 7 (7.1) |
All Subjects (n = 120) | Mortality (+) (n = 21) | Mortality (−) (n = 99) | p Value * |
Mean ± SD, pg/mL | 12.63 ± 8.11 | 10.33 ± 12.99 | 0.031 |
Median (IQR), pg/mL | 11.70 (7.20–16.40) | 6.90 (4.10–10.20) | |
ASD-PAH (n = 85) | Mortality (+) (n = 13) | Mortality (−) (n = 72) | |
Mean ± SD, pg/mL | 10.69 ± 13.69 | 9.81 ± 6.45 | 0.580 |
Median (IQR), pg/mL | 10.00 (4.45–13.55) | 7.15 (4.10–13.45) | |
I/H-PAH (n = 15) | Mortality (+) (n = 8) | Mortality (−) (n = 7) | |
Mean ± SD, pg/mL | 17.21 ± 3.12 | 18.14 ± 18.48 | 0.487 |
Median (IQR), pg/mL | 16.45 (8.90–24.23) | 9.80 (6.50–24.10) |
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Hartopo, A.B.; Anggrahini, D.W.; Dinarti, L.K.; Schäfer, A.-K.; Bergmann, A.; Fachiroh, J.; Somma, S.D. Prognostic Value for Mortality of Plasma Bioactive Adrenomedullin in Patients with Pulmonary Arterial Hypertension: A Sub Analysis of the Biomarker Study in the COHARD-PH Registry. Medicina 2023, 59, 748. https://doi.org/10.3390/medicina59040748
Hartopo AB, Anggrahini DW, Dinarti LK, Schäfer A-K, Bergmann A, Fachiroh J, Somma SD. Prognostic Value for Mortality of Plasma Bioactive Adrenomedullin in Patients with Pulmonary Arterial Hypertension: A Sub Analysis of the Biomarker Study in the COHARD-PH Registry. Medicina. 2023; 59(4):748. https://doi.org/10.3390/medicina59040748
Chicago/Turabian StyleHartopo, Anggoro Budi, Dyah Wulan Anggrahini, Lucia Kris Dinarti, Anne-Kathrin Schäfer, Andreas Bergmann, Jajah Fachiroh, and Salvatore Di Somma. 2023. "Prognostic Value for Mortality of Plasma Bioactive Adrenomedullin in Patients with Pulmonary Arterial Hypertension: A Sub Analysis of the Biomarker Study in the COHARD-PH Registry" Medicina 59, no. 4: 748. https://doi.org/10.3390/medicina59040748