Time-dependent Cox regression: serial measurement of the cardiovascular biomarker proadrenomedullin improves survival prediction in patients with lower respiratory tract infection

What Was Tested

The paper reports a study of Adrenomedullin, published as a randomized controlled trial.

The aim of this study was to determine the prognostic utility of serial measurement of the cardiovascular biomarker midregion proadrenomedullin (MR-proADM) in patients admitted with lower respiratory tract infection.

Models designed to evaluate serial biomarker measurements usually fail to answer two fundamental questions necessary to judge their clinical relevance: whether serial measurements provide additional information on top of the first measurement, and, if yes, at which time point a re-evaluation may be clinically useful.

Why It Was Studied

In a previous trial in dyspneic patients (BACH trial) the researchers could show that serial measurement of MR-proADM proves useful for risk assessment and patient monitoring.

Who Took Part

The age groups tagged for this paper are middle-aged adults, older adults and people over 80, both men and women.

The researchers apply an adapted time-dependent Cox model to data from the ProHosp trial, a prospective trial, which was observational in regards to application of prognostic biomarkers, where blood draws for biomarker evaluation were collected at day of patient inclusion, days 3, 5 and 7.

How the Study Was Run

The researchers set it up as a randomized study.

The participants were allocated by chance, so the Adrenomedullin group and the comparison group should start out alike.

In this trial, the cardiovascular biomarker MR-proADM was evaluated for its ability to predict survival in comparison to clinical risk scores.

What Was Measured

In a previous trial in dyspneic patients (BACH trial) the researchers could show that serial measurement of MR-proADM proves useful for risk assessment and patient monitoring.

PubMed files the paper under topics including Adrenomedullin, Biomarkers, Cardiovascular Diseases, Predictive Value of Tests, Protein Precursors, Regression Analysis and Respiratory Tract Infections.

What This Means in Plain Language

The paper is a randomized study of Adrenomedullin.

Results are reported in around 4 sentences of the abstract; we leave them to the paper itself rather than summarise them.

The publication is from 2012 (International journal of cardiology), a journal based in Netherlands.

More context: the Adrenomedullin compound page, all human trials.