Plasma midregional pro-adrenomedullin improves prediction of functional outcome in ischemic stroke.

<h4>Background</h4>To evaluate if plasma levels of midregional pro-adrenomedullin (MR-proADM) improve prediction of functional outcome in ischemic stroke.<h4>Methods</h4>In 168 consecutive ischemic stroke patients, plasma levels of MR-proADM were measured within 24 hours from...

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Autores principales:	Thomas Seifert-Held, Thomas Pekar, Thomas Gattringer, Nicole E Simmet, Hubert Scharnagl, Christoph Bocksrucker, Christian Lampl, Maria K Storch, Tatjana Stojakovic, Franz Fazekas
Formato:	article
Lenguaje:	EN
Publicado:	Public Library of Science (PLoS) 2013
Materias:	Medicine R Science Q
Acceso en línea:	https://doaj.org/article/b43829b2e50141c1bac2f462fdc5e100
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spelling	oai:doaj.org-article:b43829b2e50141c1bac2f462fdc5e1002021-11-18T09:03:41ZPlasma midregional pro-adrenomedullin improves prediction of functional outcome in ischemic stroke.1932-620310.1371/journal.pone.0068768https://doaj.org/article/b43829b2e50141c1bac2f462fdc5e1002013-01-01T00:00:00Zhttps://www.ncbi.nlm.nih.gov/pmc/articles/pmid/23894342/pdf/?tool=EBIhttps://doaj.org/toc/1932-6203<h4>Background</h4>To evaluate if plasma levels of midregional pro-adrenomedullin (MR-proADM) improve prediction of functional outcome in ischemic stroke.<h4>Methods</h4>In 168 consecutive ischemic stroke patients, plasma levels of MR-proADM were measured within 24 hours from symptom onset. Functional outcome was assessed by the modified Rankin Scale (mRS) at 90 days following stroke. Logistic regression, receiver operating characteristics (ROC) curve analysis, net reclassification improvement (NRI), and Kaplan-Meier survival analysis were applied.<h4>Results</h4>Plasma MR-proADM levels were found significantly higher in patients with unfavourable (mRS 3-6) compared to favourable (mRS 0-2) outcomes. MR-proADM levels were entered into a predictive model including the patients' age, National Institutes of Health Stroke Scale (NIHSS), and the use of recanalization therapy. The area under the ROC curve did not increase significantly. However, category-free NRI of 0.577 (p<0.001) indicated a significant improvement in reclassification of patients. Furthermore, MR-proADM levels significantly improved reclassification of patients in the prediction of outcome by the Stroke Prognostication using Age and NIHSS-100 (SPAN-100; NRI = 0.175; p = 0.04). Kaplan-Meier survival analysis showed a rising risk of death with increasing MR-proADM quintiles.<h4>Conclusions</h4>Plasma MR-proADM levels improve prediction of functional outcome in ischemic stroke when added to the patients' age, NIHSS on admission, and the use of recanalization therapy. Levels of MR-proADM in peripheral blood improve reclassification of patients when the SPAN-100 is used to predict the patients' functional outcome.Thomas Seifert-HeldThomas PekarThomas GattringerNicole E SimmetHubert ScharnaglChristoph BocksruckerChristian LamplMaria K StorchTatjana StojakovicFranz FazekasPublic Library of Science (PLoS)articleMedicineRScienceQENPLoS ONE, Vol 8, Iss 7, p e68768 (2013)
institution	DOAJ
collection	DOAJ
language	EN
topic	Medicine R Science Q
spellingShingle	Medicine R Science Q Thomas Seifert-Held Thomas Pekar Thomas Gattringer Nicole E Simmet Hubert Scharnagl Christoph Bocksrucker Christian Lampl Maria K Storch Tatjana Stojakovic Franz Fazekas Plasma midregional pro-adrenomedullin improves prediction of functional outcome in ischemic stroke.
description	<h4>Background</h4>To evaluate if plasma levels of midregional pro-adrenomedullin (MR-proADM) improve prediction of functional outcome in ischemic stroke.<h4>Methods</h4>In 168 consecutive ischemic stroke patients, plasma levels of MR-proADM were measured within 24 hours from symptom onset. Functional outcome was assessed by the modified Rankin Scale (mRS) at 90 days following stroke. Logistic regression, receiver operating characteristics (ROC) curve analysis, net reclassification improvement (NRI), and Kaplan-Meier survival analysis were applied.<h4>Results</h4>Plasma MR-proADM levels were found significantly higher in patients with unfavourable (mRS 3-6) compared to favourable (mRS 0-2) outcomes. MR-proADM levels were entered into a predictive model including the patients' age, National Institutes of Health Stroke Scale (NIHSS), and the use of recanalization therapy. The area under the ROC curve did not increase significantly. However, category-free NRI of 0.577 (p<0.001) indicated a significant improvement in reclassification of patients. Furthermore, MR-proADM levels significantly improved reclassification of patients in the prediction of outcome by the Stroke Prognostication using Age and NIHSS-100 (SPAN-100; NRI = 0.175; p = 0.04). Kaplan-Meier survival analysis showed a rising risk of death with increasing MR-proADM quintiles.<h4>Conclusions</h4>Plasma MR-proADM levels improve prediction of functional outcome in ischemic stroke when added to the patients' age, NIHSS on admission, and the use of recanalization therapy. Levels of MR-proADM in peripheral blood improve reclassification of patients when the SPAN-100 is used to predict the patients' functional outcome.
format	article
author	Thomas Seifert-Held Thomas Pekar Thomas Gattringer Nicole E Simmet Hubert Scharnagl Christoph Bocksrucker Christian Lampl Maria K Storch Tatjana Stojakovic Franz Fazekas
author_facet	Thomas Seifert-Held Thomas Pekar Thomas Gattringer Nicole E Simmet Hubert Scharnagl Christoph Bocksrucker Christian Lampl Maria K Storch Tatjana Stojakovic Franz Fazekas
author_sort	Thomas Seifert-Held
title	Plasma midregional pro-adrenomedullin improves prediction of functional outcome in ischemic stroke.
title_short	Plasma midregional pro-adrenomedullin improves prediction of functional outcome in ischemic stroke.
title_full	Plasma midregional pro-adrenomedullin improves prediction of functional outcome in ischemic stroke.
title_fullStr	Plasma midregional pro-adrenomedullin improves prediction of functional outcome in ischemic stroke.
title_full_unstemmed	Plasma midregional pro-adrenomedullin improves prediction of functional outcome in ischemic stroke.
title_sort	plasma midregional pro-adrenomedullin improves prediction of functional outcome in ischemic stroke.
publisher	Public Library of Science (PLoS)
publishDate	2013
url	https://doaj.org/article/b43829b2e50141c1bac2f462fdc5e100
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Plasma midregional pro-adrenomedullin improves prediction of functional outcome in ischemic stroke.

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