Work

Role of Adrenomedullin as a Prognostic Biomarker in Acute Heart Failure Patients: A Systematic Review and Meta-Analysis

Year: 2026

Type: review

Study designs: Systematic Review, Meta-Analysis

Abstract: INTRODUCTION: Residual congestion is associated with a high rehospitalization rate in acute heart failure (HF) patients. This study aimed to evaluate the role of adrenomedullin (mid-regional pro-adrenomedullin [MR-pro ADM] and bioactive adrenomedullin [bio-ADM]) as a prognostic marker of tissue congestion with clinical outcomes in acute HF patients. METHODS: Three databases were systematically searched until November 2024 to include both observational and post hoc clinical trial studies that suit the research question. Outcomes assessed are clinical outcomes of in-hospital mortality, composite outcome of all-cause mortality and major adverse cardiovascular events (MACEs), and HF rehospitalization. Statistical analyses conducted are pooled hazard ratio (HR), correlation coefficient, and area under the curve with a random-effects model. RESULTS: Twenty-one studies of 18,110 patients with low to medium risk of bias are included of which 20 of them are prospective cohort studies. Both MR-pro ADM and bio-ADM measured at admission or discharge are associated with a statistically significant increasing risk of composite outcome, MACE outcome, and all-cause mortality (HR 1.17-2.72). MR-pro ADM is also associated with a statistically significant increasing risk of in-hospital mortality and HF rehospitalization (HR 1.72-2.20). Bio-ADM measured at discharge is found to have a better prognostic value for all-cause mortality outcome than bio-ADM measured at admission (HR 1.90 and 1.17, respectively, p 0.007). MR-pro ADM showed a strong and moderate linear correlation with bio-ADM and NT-proBNP (R 0.784, 0.461, respectively). CONCLUSION: MR-pro ADM and bio-ADM are both reliable prognostic markers in acute HF patients.

Source: Cardiology

DOI: 10.1159/000550611