ArticleEuropean heart journal2025
Proenkephalin improves cardio-renal risk prediction in acute coronary syndromes: the KID-ACS score.
Article in European heart journal, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 9 papers.
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Who cites it
9 citing papers in PubMed.
- Early EASIX and Short-Term Mortality After Acute Myocardial Infarction: A Dual-Cohort Prognostic Study.Journal of clinical medicine · 2026Article
- Gut microbiota-derived imidazole propionate predicts cardiometabolic risk in patients with coronary artery disease.European heart journal · 2026Article
- Beyond Creatinine: Novel Renal Biomarkers at the Interface of Kidney Injury and Cardiovascular Risk.Biomedicines · 2026Review
- Multi-biomarker approach for predicting cardiac magnetic resonance parameters at 30 days after ST-segment elevation myocardial infarction.International journal of cardiology. Heart & vasculature · 2026Article
- Integrating Novel Biomarkers into Clinical Practice: A Practical Framework for Diagnosis and Management of Cardiorenal Syndrome.Life (Basel, Switzerland) · 2025Review
- The role of artificial intelligence in cardiovascular research: Fear less and live bolder.European journal of clinical investigation · 2025Review
- Implementation and One-Year Evaluation of Proenkephalin A in Critical Care.International journal of molecular sciences · 2025Article
- Impact of stress hyperglycemia ratio on acute kidney injury and mortality in patients with cardiogenic shock: a retrospective analysis.Frontiers in endocrinology · 2025Article
- Diagnostic Value of Long Non-Coding RNA NORAD in Acute Coronary Syndrome: A Diagnostic Biomarker Study.Journal of inflammation research · 2025Article
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36 authors.
Funding
Abstract
BACKGROUND AND
aimsCirculating proenkephalin (PENK) is a stable endogenous polypeptide with fast response to glomerular dysfunction and tubular damage. This study examined the predictive value of PENK for renal outcomes and mortality in patients with acute coronary syndrome (ACS).
methodsProenkephalin was measured in plasma in a prospective multicentre ACS cohort from Switzerland (n = 4787) and in validation cohorts from the UK (n = 1141), Czechia (n = 927), and Germany (n = 220). A biomarker-enhanced risk score (KID-ACS score) for simultaneous prediction of in-hospital acute kidney injury (AKI) and 30-day mortality was derived and externally validated.
resultsOn multivariable adjustment for established risk factors, circulating PENK remained associated with in-hospital AKI [per log2 increase: adjusted odds ratio 1.53, 95% confidence interval (CI) 1.13-2.09, P = .007] and 30-day mortality (adjusted hazard ratio 2.73, 95% CI 1.85-4.02, P < .001). The KID-ACS score integrates PENK and showed an area under the receiver operating characteristic curve (AUC) of .72 (95% CI .68-.76) for in-hospital AKI and .91 (95% CI .87-.95) for 30-day mortality in the derivation cohort. Upon external validation, KID-ACS achieved similarly high performance for in-hospital AKI (Zurich: AUC .73, 95% CI .70-.77; Czechia: AUC .75, 95% CI .68-.81; Germany: AUC .71, 95% CI .55-.87) and 30-day mortality (UK: AUC .87, 95% CI .83-.91; Czechia: AUC .91, 95% CI .87-.94; Germany: AUC .96, 95% CI .92-1.00), outperforming the contrast-associated AKI score and the Global Registry of Acute Coronary Events 2.0 score, respectively.
conclusionsCirculating PENK offers incremental value for predicting in-hospital AKI and mortality in ACS. The simple six-item KID-ACS risk score integrates PENK and provides a novel tool for simultaneous assessment of renal and mortality risk in patients with ACS.
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