Midregional proadrenomedullin (mr-PROADP) and midregional pro-atrial natriuretic peptid (MR-proanp) levels in cases with acute pulmonary tromboembolism

Pulmonary embolism is a disease with impaired hemostatic balance and high morbidity and mortality rate. In this disease, there is a necessity for new markers about diagnostic and prognostic processes. In our study, it is aimed to determine levels of cardiac markers MR-proADM and MR-proANP at acute cases with PE, also to determine relationship between this parameters and severity of disease, risk classification and to determine relationship between 1-3 month mortality. 82 pulmonary embolism patients diagnosed with multidetector pulmonary BT – angiography and/or ventilation perfusion scintigraphy (V/Q) included in the study with a control group consists of from 50 healthy participants. Demographic informations and physical examination findings were recorded and ather blood gas sample and for MR-proADM and MR-proANP blood samples were taken; plasma D-dimer, troponin I (TnI) and serum brain natriuretic peptide (BNP) values recorded. Severity of acute PE was determined according to systolic blood pressure, findings of initial echocardiographic evaluation right ventricular dysfunction (RVD) and plasma TnI and BNP levels as stated in the guidebook of European Society of Cardiology. After these initial measurements, cases with PE were assessed in terms of all causative and PE related mortalities during hospitality. 82 acute cases with PE [40 male (48.8 %) and 42 female (51.2 %) with an average age of 64.96 ± 17.24] and healthy control group consists of 50 participants [23 male (46 %) and 27 female (54 %) with an average age of 66.16 ± 14.06] included in the study. The mean serum MR-proANP and MR-proADM levels in acute PE patients were found to be statistically higher than the control group (p<0.001, p<0.1; respectively). Also, mean serum MR-proANP and MR-proADM levels were found statistically significantly higher in patients under high clinical risk than patients under low clinical risk. Any statistical difference did not determined in high-risk cases of sPESI when compared with low-risk cases although hospital mortality rates have been higher. It was determined that the hospital mortality rate in cases with MR-proANP ≥ 123.30 pmol/L and the total mortality rate in cases with MR-proANP ≥ 123.30 pmol/L showed a statistically significant increase. In conclusion, this study shows MR-proANP and MR-proADM could be an important biochemical marker for determining high risk cases and predicting the mortality of PE patients and we think these results should be supported by further and extensive studies. Key words: Pulmonary embolism, Midregional Proadrenomedullin (MR-proADM) ve Midregional Proatrial Natriüretik Peptid, mortality.