High levels of atrial natriuretic peptide and copeptin and mortality risk [Asociación de valores elevados de péptido natriurético auricular y copeptina con riesgo de mortalidad]
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Objective To determine whether high levels of mid-regional pro-atrial natriuretic peptide (MR-proANP), copeptin, and procalcitonin (PCT) plasma concentrations are associated with increased mortality risk. Methods Prospective observational study including 254 critically ill children. MR-proANP, copeptin and PCT were compared between children with high (Group A; n = 33) and low (Group B; n = 221) mortality risk, and between patients with failure of more than 1 organ (Group 1; n = 71) and less than 2 (Group 2; n = 183). Results Median (range) of MR-proANP, copeptin, and PCT levels in group A vs B were, respectively: 209.4 (30.5–1415.8) vs. 75.0 (14.6–867.2) pmol/L (P<.001); 104.4 (7.4–460.9) vs. 26.6 (0.00–613.1) pmol/L (P<.001), and 7.8 (0.3–552.0) vs. 0.3 (0.02–107.0) ng/mL (P<.001). The area under the curve (AUC) for the differentiation of group A and B was 0.764 (95% CI: 0.674-0.854) for MR-proANP; 0.735 (0.642-0.827) for copeptin, and 0.842 (0.744-0.941) for PCT, with no statistical differences. The AUCs for the differentiation of group 1 and 2 were: 0.837 (0.784-0.891) for MR-proANP, 0.735 (0.666-0.804) for copeptin, and 0.804 (0.715-0.892) for PCT, with statistical differences between MR-proANP and copeptin, P=.01. Conclusions High levels of MR-proANP, copeptin and PCT were associated with increased mortality risk scores. MR-proANP showed a higher association than copeptin with number of organs in failure. © 2015 Asociación Española de Pediatría
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