Acute cardiac care & resuscitation
Mid-regional pro-adrenomedullin and lactate levels for risk stratification in patients with out-of-hospital cardiac arrest
Authors' conclusion
Higher MR-proADM concentrations are associated with an increased risk of death in patients with OHCA, and the combination of high MR-proADM and lactate levels identifies patients at a distinctly elevated risk.
Study context
- Population
- Patients with out-of-hospital cardiac arrest (OHCA) who survived at least 24 h after return of spontaneous circulation
- Participants
- 232 patients
- Exposure
- High vs low mid-regional pro-adrenomedullin (MR-proADM) concentrations
- Outcome
- All-cause death
- Follow-up
- 28 days
Main finding
As reported in the abstract
Death
Adjusted hazard ratio (95% CI)
Q4vs Q1-Q3multivariable adjusted, incl. lactate at 24 h
1.67(1.12–2.50)
1-unit increase in standardized MR-proADM
1.44(1.19–1.73)
Observational data: associations, not effects.
Further findings
Death, combination of high MR-proADM and high lactate (Q4)
| Adjusted HR (95% CI) | ||
|---|---|---|
| High MR-proADM and high lactate (Q4) | 3.50 (1.92–6.39) | |
| 0.10.31310Adjusted hazard ratio (log scale) |
Biomarker levels at 24 h
- Correlation of MR-proADM with lactate (weak)
- r = 0.36, P < 0.001
- Median MR-proADM 1.4 nmol/L (IQR 0.8-2.8 nmol/L)
- Median lactate 1.8 mmol/L (IQR 1.3-3.4 mmol/L)
Original publication
Mid-regional pro-adrenomedullin and lactate levels for risk stratification in patients with out-of-hospital cardiac arrest. Eur Heart J Acute Cardiovasc Care. Published 21 March 2023. doi:10.
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