Acute cardiac care & resuscitationCohort study
Adrenomedullin system dysregulation predicts cardiogenic shock and mortality in acute coronary syndromes
- Prospective cohort study
- multicentre
- external validation cohort
Authors' conclusion
ADM-Gly and bio-ADM, but not PAM, independently predict in-hospital CS and 1-year mortality risk in initially stable patients with ACS and improve early risk stratification.
Study context
- Population
- Acute coronary syndromes (ACS) patients without cardiogenic shock (CS) on admission
- Participants
- 4,098 vs 824
- Exposure
- Adrenomedullin (ADM) system biomarkers per log2 increase
- SPUM-ACSn = 4,098
- FAST-MIn = 824
- Outcome
- In-hospital CS
- Follow-up
- In-hospital
Main finding
As reported in the abstract
Estimate (95% CI)P value
ADM-GlySwitzerland
aOR per log2 increase 1.44(1.22–1.71)
P < 0.001bio-ADMSwitzerland
aOR per log2 increase 1.37(1.10–1.70)
P = 0.004ADM-GlyFrance
adjusted RR per log2 increase 1.82(1.34–2.48)
P < 0.001bio-ADMFrance
aRR per log2 increase 1.55(1.15–2.10)
P = 0.004Observational data: associations, not effects.
Secondary outcomes
1-year mortality
| Comparison | aHR per log2 increase (95% CI) | P value | |
|---|---|---|---|
| ADM-Gly | 1.33 (1.09–1.61) | P = 0.005 | |
| bio-ADM | 1.46 (1.15–1.86) | P = 0.002 | |
| 0.512Ahr per log2 increase (log scale) |
Incremental value of ADM-Gly + bio-ADM added to ORBI risk score
- Δ AUC
- 0.02
- Net reclassification improvement
- 0.229
- Δ Akaike information criterion
- −26.9
- consistent results in external validation
Original publication
Adrenomedullin system dysregulation predicts cardiogenic shock and mortality in acute coronary syndromes. Eur Heart J. Published 30 August 2026. doi:10.1093/eurheartj/ehag636
Summarised from the published abstract; every number is checked against it