A pilot study on the diagnostic accuracy of proadrenomedullin and proatrial natriuretic Peptide in lower respiratory tract infections

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2014Author
Ruiz González, Agustín
Esquerda, Aureli
Valencia, Horacio
Cao, Gonzalo
Falguera i Sacrest, Miquel
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Ruiz González, Agustín;
Esquerda, Aureli;
Porcel Pérez, José Manuel;
Bielsa Martín, Silvia;
Valencia, Horacio;
Cao, Gonzalo;
Falguera i Sacrest, Miquel;
.
(2014)
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A pilot study on the diagnostic accuracy of proadrenomedullin and proatrial natriuretic Peptide in lower respiratory tract infections.
The Open Respiratory Medicine Journal, 2014, vol. 8, p. 22-27.
https://doi.org/10.2174/1874306401408010022.
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Abstract: Background: Pneumonia is the leading cause of death among infectious diseases in developed countries.
However, the severity of pneumonia requiring hospitalization often makes the initial diagnosis difficult because of an
equivocal clinical picture or interpretation of the chest film. The objective of the present study was to assess the
usefulness of the plasma levels of mid-regional proadrenomedullin (MR-proADM) and mid-regional proatrial natriuretic
peptide (MR-proANP) in differentiating pneumonia from other lower respiratory tract infections (LRTIs).
Methods: A retrospective study was conducted. The plasma levels of MR-proADM and MR-proANP were measured in 85
patients hospitalized for LRTIs, 56 of whom with diagnosis of pneumonia and 29 with other LRTIs.
Results: The patients with pneumonia had increased MR-proADM levels (median 1.46 nmol/L [IQR 25-75, 0.82-2.02
nmol/L]) compared with the patients with other LRTIs (median 0.88 nmol/mL [0.71-1.39 nmol/L]) (p= 0.04). However,
the MR-proANP levels did not show differences between the groups. The optimal threshold of MR-proADM to predict
pneumonia was 1.5 nmol/L, which yielded a sensitivity of 51.7% (95% CI, 38.0-65.3), a 79.3% specificity (95% CI, 60.3-
92.0), and an odds ratio of 6.64 (95% CI, 1.32-32.85). The combination of this parameter with C-reactive protein in an
“and” rule increased the specificity for detecting pneumonia significantly.
Conclusion: MR-proADM levels (but not MR-proANP levels) are increased in patients with pneumonia although its
discriminatory power is moderate.
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The Open Respiratory Medicine Journal, 2014, vol. 8, p. 22-27European research projects
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