The researchers found that the MR-proADM test was prognostically accurate 73.1 percent of the time, making it superior to both the B-Natriuretic peptide (BNP) test (60.6 percent) and the NTproBNP test (63 percent), which measures a biological fragment associated with BNP.
Shortness of breath is a common symptom of patients arriving at the emergency room, but it can have many causes including asthma or other lung problems, respiratory infections, heart failure and many other conditions, he explained. Heart failure is the cluster of symptoms - including shortness of breath - that reflects the heart's inability to pump enough blood to oxygenate all the body's tissues adequately.
"A significant percentage of emergency room patients have heart failure and the BNP and NTproBNP tests have long been used to identify heart failure patients in the emergency setting," said Alan Maisel, M.D., the study's principal investigator and a long-standing BNP researcher at the University of California, San Diego Medical Center. "Both tests measure elevations in proteins released by the distressed heart as it tries to keep the blood's salt and water balance stable."
MR-proADM indirectly measures a hormone called adrenomedullin, which affects blood vessel dilation and is implicated in many cardiac and infectious diseases. Because the hormone, ADM, is very unstable, it was necessary to develop an indirect test for it, Anker said.
Previous retrospective studies by the same research group suggested that the MR-proADM test is useful in assessing disease severity and predicting prognosis in patients with heart failure. The BACH study validated these results and found the MR-proADM to be superior to anything previously available at correctly identifying the sickest heart failure patients, Anker said.
"Better prognostic markers help patient
|SOURCE American Heart Association|
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