Evidence map›Paper›PMID 34302189›Full record

ArticleClinical research in cardiology : official journal of the German Cardiac Society2022

Activity of the adrenomedullin system to personalise post-discharge diuretic treatment in acute heart failure.

Nikola Kozhuharov, Leong Ng, Desiree Wussler, Ivo Strebel, Zaid Sabti, Oliver Hartmann, Mohamed Eltayeb, Iain Squire, Albina Nowak, Max Rieger and 15 more

Open access · hybridAbstract readMulticenter Study
PubMed Full text at PMC Publisher
In one paragraph

Article in Clinical research in cardiology : official journal of the German Cardiac Society, 2022. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 10 papers, 1 of them a synthesis that pooled it.

0numbers the graph read from it
0cells of the map it votes in
10citing papers in PubMed, 1 pooled it
2.0field-weighted citation impact, top 12% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

10 citing papers in PubMed, 1 synthesis or guideline pooled it, 17 citations in OpenAlex.

  1. Pooled it
  2. Diagnostic and prognostic utility of bone morphogenetic protein 10 in acute dyspnea: a cohort study.Clinical research in cardiology : official journal of the German Cardiac Society · 2026
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4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

25 authors at 5 institutions in 5 countries.

Nikola Kozhuharov *Department of Cardiology and Cardiovascular Research Institute Basel (CRIB), University Hospital Basel and University of Basel, Petersgraben 4, CH-4031, Basel, Switzerland.
Leong Ng *Department of Cardiovascular Sciences, University of Leicester, Leicester, UK.
Desiree WusslerDepartment of Cardiology and Cardiovascular Research Institute Basel (CRIB), University Hospital Basel and University of Basel, Petersgraben 4, CH-4031, Basel, Switzerland.
Ivo StrebelDepartment of Cardiology and Cardiovascular Research Institute Basel (CRIB), University Hospital Basel and University of Basel, Petersgraben 4, CH-4031, Basel, Switzerland.
Zaid SabtiDepartment of Cardiology and Cardiovascular Research Institute Basel (CRIB), University Hospital Basel and University of Basel, Petersgraben 4, CH-4031, Basel, Switzerland.
Oliver HartmannSphingotec GmbH, Hennigsdorf, Germany.
Mohamed EltayebDepartment of Cardiovascular Sciences, University of Leicester, Leicester, UK.
Iain SquireDepartment of Cardiovascular Sciences, University of Leicester, Leicester, UK.
Albina NowakDepartment of Cardiology and Cardiovascular Research Institute Basel (CRIB), University Hospital Basel and University of Basel, Petersgraben 4, CH-4031, Basel, Switzerland.
Max RiegerDepartment of Cardiology and Cardiovascular Research Institute Basel (CRIB), University Hospital Basel and University of Basel, Petersgraben 4, CH-4031, Basel, Switzerland.
Jasmin MartinDepartment of Cardiology and Cardiovascular Research Institute Basel (CRIB), University Hospital Basel and University of Basel, Petersgraben 4, CH-4031, Basel, Switzerland.
Eleni MichouDepartment of Cardiology and Cardiovascular Research Institute Basel (CRIB), University Hospital Basel and University of Basel, Petersgraben 4, CH-4031, Basel, Switzerland.
Sabrina StefanelliDepartment of Cardiology and Cardiovascular Research Institute Basel (CRIB), University Hospital Basel and University of Basel, Petersgraben 4, CH-4031, Basel, Switzerland.
Christian PuelacherDepartment of Cardiology and Cardiovascular Research Institute Basel (CRIB), University Hospital Basel and University of Basel, Petersgraben 4, CH-4031, Basel, Switzerland.
Samyut ShresthaDepartment of Cardiology and Cardiovascular Research Institute Basel (CRIB), University Hospital Basel and University of Basel, Petersgraben 4, CH-4031, Basel, Switzerland.
Maria BelkinDepartment of Cardiology and Cardiovascular Research Institute Basel (CRIB), University Hospital Basel and University of Basel, Petersgraben 4, CH-4031, Basel, Switzerland.
Tobias ZimmermannDepartment of Cardiology and Cardiovascular Research Institute Basel (CRIB), University Hospital Basel and University of Basel, Petersgraben 4, CH-4031, Basel, Switzerland.
Pedro Lopez-AyalaDepartment of Cardiology and Cardiovascular Research Institute Basel (CRIB), University Hospital Basel and University of Basel, Petersgraben 4, CH-4031, Basel, Switzerland.
Joachim StruckSphingotec GmbH, Hennigsdorf, Germany.
Andreas BergmannSphingotec GmbH, Hennigsdorf, Germany.
Alexandre MebazaaUniversity Paris Diderot, APHP Hôpitaux Universitaires Saint Louis Lariboisière, Inserm 942, Paris, France.
Alice BletUniversity Paris Diderot, APHP Hôpitaux Universitaires Saint Louis Lariboisière, Inserm 942, Paris, France.
Danielle Menosi GualandroDepartment of Cardiology and Cardiovascular Research Institute Basel (CRIB), University Hospital Basel and University of Basel, Petersgraben 4, CH-4031, Basel, Switzerland.
Tobias BreidthardtDepartment of Cardiology and Cardiovascular Research Institute Basel (CRIB), University Hospital Basel and University of Basel, Petersgraben 4, CH-4031, Basel, Switzerland.
Christian MuellerDepartment of Cardiology and Cardiovascular Research Institute Basel (CRIB), University Hospital Basel and University of Basel, Petersgraben 4, CH-4031, Basel, Switzerland. christian.mueller@usb.ch.ORCID http://orcid.org/0000-0002-1120-6405
University of Basel · CHUniversity of Leicester · GBInserm · FREducation and Research Network · INUniversity of Liverpool · GB

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundQuantifying the activity of the adrenomedullin system might help to monitor and guide treatment in acute heart failure (AHF) patients. The aims were to (1) identify AHF patients with marked benefit or harm from specific treatments at hospital discharge and (2) predict mortality by quantifying the adrenomedullin system activity.

methodsThis was a prospective multicentre study. AHF diagnosis and phenotype were centrally adjudicated by two independent cardiologists among patients presenting to the emergency department with acute dyspnoea. Adrenomedullin system activity was quantified using the biologically active component, bioactive adrenomedullin (bio-ADM), and a prohormone fragment, midregional proadrenomedullin (MR-proADM). Bio-ADM and MR-proADM concentrations were measured in a blinded fashion at presentation and at discharge. Interaction with specific treatments at discharge and the utility of these biomarkers on predicting outcomes during 365-day follow-up were assessed.

resultsAmong 1886 patients with adjudicated AHF, 514 patients (27.3%) died during 365-day follow-up. After adjusting for age, creatinine, and treatment at discharge, patients with bio-ADM plasma concentrations above the median (> 44.6 pg/mL) derived disproportional benefit if treated with diuretics (interaction p values < 0.001). These findings were confirmed when quantifying adrenomedullin system activity using MR-proADM (n = 764) (interaction p values < 0.001). Patients with bio-ADM plasma concentrations above the median were at increased risk of death (hazard ratio 1.87, 95% CI 1.57-2.24; p < 0.001). For predicting 365-day all-cause mortality, both biomarkers performed well, with MR-proADM presenting an even higher predictive accuracy compared to bio-ADM (p < 0.001).

conclusionsQuantifying the adrenomedullin's system activity may help to personalise post-discharge diuretic treatment and enable accurate risk-prediction in AHF.

Indexed as

AdrenomedullinHeart FailureAftercareBiomarkersDiureticsHumansPatient DischargePrognosisProspective StudiesAdrenomedullinBiomarkersDiureticsAcute heart failureAdrenomedullinDiureticsDyspnoea

Identifiers

PMID34302189
PMCPMC9151518
OpenAlexW3184518676

What OpenQuestion holds

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Registered trials

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.