Diagnostic performance of mid-regional pro-adrenomedullin as an analyte for the exclusion of left ventricular dysfunction

Aims In ambulatory patients with coronary artery disease (CAD) we aimed to evaluate the diagnostic performance of mid-regional pro-adrenomedullin (MR-proADM) for the detection or exclusion of impaired left ventricular ejection fraction (LVEF). Methods and results MR-proADM levels were measured in blood samples taken from 102 outpatients with CAD classified according to the New York Heart Association (NYHA) and Canadian Cardiovascular society (CCS) I–II. Increased levels of MR-proADM correlated with impaired LVEF (r = − 0.21, p = 0.046). The optimal threshold of MR-proADM for identification of impaired LVEF < 50% was 0.54 nmol/L with an area under the ROC curve (AUC) of 0.64 (p = 0.06). In univariate and multivariate calculation, MR-proADM > 0.54 nmol/L remained associated with left ventricular dysfunction even after adjusting for age and gender. The negative predictive value (NPV) for MR-proADM ≤ 0.54 nmol/L was 88%, the specificity was 66%. Conclusions We showed that MR-proADM is related to impaired LVEF. With an NPV of 88% MR-proADM might be a supportive tool to exclude negatively tested outpatients with CAD from further LVEF-diagnosis with moderate reliability.