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Prognostic Value of Secretoneurin in Patients with Acute Respiratory Failure: Data from the FINNALI Study
Akershus Univ Hosp, Div Med, Sykehusveien 25, N-1478 Lorenskog, Norway.;Univ Oslo, Ctr Heart Failure Res, Oslo, Norway..
Akershus Univ Hosp, Div Med, Sykehusveien 25, N-1478 Lorenskog, Norway.;Univ Oslo, Ctr Heart Failure Res, Oslo, Norway..
Oslo Univ Hosp Ulleval, Ctr Clin Heart Res, Oslo, Norway.;Univ Helsinki, Intens Care & Pain Med, Dept Anesthesiol, Div Intens Care Med, Helsinki, Finland.;Helsinki Univ Hosp, Helsinki, Finland..
Oslo Univ Hosp Ulleval, Ctr Clin Heart Res, Oslo, Norway.;Univ Helsinki, Intens Care & Pain Med, Dept Anesthesiol, Div Intens Care Med, Helsinki, Finland.;Helsinki Univ Hosp, Helsinki, Finland..
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2016 (English)In: Clinical Chemistry, ISSN 0009-9147, E-ISSN 1530-8561, Vol. 62, no 10, 1380-1389 p.Article in journal (Refereed) Published
Abstract [en]

BACKGROUND: We examined whether secretoneurin (SN), a biomarker associated with cardiomyocyte Ca2+ handling, provides prognostic information in patients with acute respiratory failure (ARF).

METHODS: We included 490 patients with ARF, defined as ventilatory support >6 h, with blood samples available on admission to the intensive care unit (ICU). SN concentrations were measured by RIA.

RESULTS: A total of 209 patients (43%) were hospitalized with cardiovascular (CV)-related ARF, and 90-day mortality rates were comparable between CV- and non CV-related ARF (n = 281): 31% vs 24%, P = 0.11. Admission SN concentrations were higher in nonsurvivors than in survivors in both CV -related (median 148 [quartile 1-3, 117-203] vs 108 [87-143] pmol/L, P < 0.001) and non CV-related ARF (139 [115-184] vs 113 [91-139] pmol/L, P < 0.001). In patients with CV -related ARF, SN concentrations on ICU admission were associated with 90-day mortality [odds ratio (OR) 1.97 (95% CI, 1.04-3.73, P = 0.04)] after adjusting for established risk indices, including N-terminal-pro-B-type natriuretic peptide (NT-proBNP) concentrations. SN also improved patient classification in CV -related ARF as assessed by the net reclassification index: 0.32 (95% CI, 0.04-0.59), P = 0.03. The area under the curve (AUC) of SN to predict mortality in patients with CV -related ARF was 0.72 (95% CI, 0.65-0.79), and the AUC of NT-proBNP was 0.64 (0.56-0.73). In contrast, SN concentrations on ICU admission did not provide incremental prognostic value to established risk indices in patients with non CV-related ARF, and the AUC was 0.67 (0.60-0.75).

CONCLUSIONS: SN concentrations measured on ICU admission provided incremental prognostic information to established risk indices in patients with CV -related ARF, but not in patients with non CV-related ARF.

Place, publisher, year, edition, pages
2016. Vol. 62, no 10, 1380-1389 p.
National Category
Medical and Health Sciences
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URN: urn:nbn:se:uu:diva-306737DOI: 10.1373/clinchem.2016.258764ISI: 000384629000015PubMedID: 27540029OAI: oai:DiVA.org:uu-306737DiVA: diva2:1045499
Available from: 2016-11-09 Created: 2016-11-03 Last updated: 2016-11-09Bibliographically approved

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