Endothelial Biomarkers Are Superior to Classic Inflammatory Biomarkers in Community-Acquired Pneumonia.

IF 3.9 3区 工程技术 Q2 BIOCHEMISTRY & MOLECULAR BIOLOGY
Paula González-Jiménez, Mónica Piqueras, Ana Latorre, Jordi Tortosa-Carreres, Noé Mengot, Ricardo Alonso, Soledad Reyes, Isabel Amara-Elori, Luis Martínez-Dolz, Antonio Moscardó, Rosario Menéndez, Raúl Méndez
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Abstract

Background: Complications in community-acquired pneumonia (CAP), including cardiovascular events (CVE), can occur during an acute episode and in the long term. We aimed to analyse the role of endothelial damage biomarkers (C-terminal endothelin-1 precursor fragment [CT-proET-1] and mid-regional pro-adrenomedullin [MR-proADM]), in contrast to classic inflammation markers (C Reactive Protein [CRP] and procalcitonin [PCT]) in patients admitted for CAP and their relationship with ICU admission, CVE and mortality in the short and long term; Methods: Biomarkers were analysed in 515 patients with CAP at day 1, 285 at day 5 and 280 at day 30. Traditional inflammatory biomarkers and endothelial damage biomarkers were measured. ICU admission, CVE and mortality (in-hospital and 1-year follow-up) were assessed using receiver operating characteristic (ROC) curve analysis and univariate logistic regression. Results: A statistically significant association was observed between initial, raised CT-proET-1 and MR-proADM levels, the need for ICU admission and the development of in-hospital CVE or in-hospital mortality. Both endothelial markers maintained a strong association at day 30 with 1-year follow-up CVE. At day 1, CRP and PCT were only associated with ICU admission. On day 30, there was no association between inflammatory markers and long-term CVE or death. The odds ratio (OR) and area under the curve (AUC) of endothelial biomarkers were superior to those of classic biomarkers for all outcomes considered. Conclusions: Endothelial biomarkers are better indicators than classic ones in predicting worse outcomes in both the short and long term, especially CVE. MR-proADM is the best biomarker for predicting complications in CAP.

社区获得性肺炎的内皮生物标志物优于传统的炎症生物标志物
背景:社区获得性肺炎(CAP)的并发症,包括心血管事件(CVE),可发生在急性发作期和长期。我们的目的是分析内皮损伤生物标志物(C-端内皮素-1 前体片段 [CT-proET-1] 和中区前肾上腺髓质素 [MR-proADM])与传统炎症标志物(C 反应蛋白 [CRP] 和降钙素原 [PCT])在 CAP 患者中的作用,以及它们在短期和长期内与入住 ICU、CVE 和死亡率之间的关系:对 515 名 CAP 患者第 1 天、285 名第 5 天和 280 名第 30 天的生物标志物进行了分析。测量了传统的炎症生物标志物和内皮损伤生物标志物。采用接收器操作特征曲线(ROC)分析和单变量逻辑回归评估了入住 ICU、CVE 和死亡率(院内和 1 年随访)。结果观察发现,CT-proET-1和MR-proADM的初始水平升高、入住重症监护室的需求和院内CVE的发生或院内死亡率之间存在统计学意义上的明显关联。两种内皮标志物在第30天与1年随访的CVE之间保持着很强的相关性。在第1天,CRP和PCT仅与入住ICU有关。在第30天,炎症标志物与长期CVE或死亡之间没有关联。就所有结果而言,内皮生物标志物的几率(OR)和曲线下面积(AUC)均优于传统生物标志物。结论:内皮生物标志物是比传统生物标志物更好的预测短期和长期不良后果的指标,尤其是 CVE。MR-proADM 是预测 CAP 并发症的最佳生物标志物。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
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来源期刊
Biomedicines
Biomedicines Biochemistry, Genetics and Molecular Biology-General Biochemistry,Genetics and Molecular Biology
CiteScore
5.20
自引率
8.50%
发文量
2823
审稿时长
8 weeks
期刊介绍: Biomedicines (ISSN 2227-9059; CODEN: BIOMID) is an international, scientific, open access journal on biomedicines published quarterly online by MDPI.
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