Mid-regional pro-adrenomedullin in the early evaluation of acute chest pain patients ☆ ☆☆

Abstract Background The purpose of this study was to investigate the utility of mid-regional pro-adrenomedullin (MR-proADM) in the early diagnosis and risk stratification of patients with acute chest pain in comparison with established and novel biomarkers and risk scores. Methods In this prospective, observational, international, multi-center trial (APACE), MR-proADM was determined in 1179 unselected patients with acute chest pain. Patients were followed for 24months. Results MR-proADM concentrations at presentation were higher in patients with AMI (median: 0.78nmol/l, IQR 0.60–1.13) than in patients with other diagnoses (0.64nmol/l, IQR 0.49–0.86nmol/l; p 0.90nmol/l). Adding MR-proADM to the TIMI-score (AUC 0.87) predicted 1-year mortality more accurately than the TIMI-score alone (AUC 0.82; p Conclusions While MR-proADM does not have clinical utility in the early diagnosis of AMI or predicting cardiovascular events in patients with acute chest pain, it may provide prognostic value for all-cause mortality.