Prognostic value of chromograninA at admission in critically ill patients
Abstract number: P1821
Metz-Boutigue M.H., Schneider F., Lavaux T., Zhang D., Herbrecht J.E., Bach C., Chung H., Garnero P., Aunis D.
Objectives: Critically ill patients are usually admitted with clinical and biochemical signs of systemic inflammation as a consequence of their disease. A recent study was conducted to evaluate the significance of Chromogranin A (CGA), a stress marker released by chromaffin cells and neutrophils, for prognosis of critically ill patients with systemic inflammatory response syndrome (SIRS) or sepsis [Zhang D and al., Clin Chem, 2009]. This study is now completed by a comparative proteomic analysis of the CGA-derived peptides present in serum from patients and healthy controls.
Methods: We measured in 53 patients and 14 healthy controls the serum concentration of CGA, procalcitonin and C-reactive protein. We also assessed the Simplified Acute Physiological Score (SAPS) in the patients. The proteomic analysis of the CGA-derived peptides present in serum was performed by using reverse phase HPLC and Western blot.
Results: Serum CGA concentrations were significantly increased in SIRS patients when compared to healthy controls, with a median value of 115 mg/L. When infection was associated with SIRS, patients had the highest increase in CGA with a median value of 138.5 mg/L. CGA concentrations positively correlated with inflammation markers (procalcitonin, C-reactive protein) and the Simplified Acute Physiological Score (SAPS II). Receiver Operating Characteristic (ROC) analysis showed that CGA is equivalent to SAPS as an indicator for 28-days mortality. We reported also the comparative expression of complete CGA and its natural derived fragments in serum of critically ill patients and healthy controls. These data are related to the processing machinery acting during sepsis.
Conclusion: Patients with CGA concentration superior to 71 mg/L have a significantly shorter survival. A Cox model confirmed that CGA and SAPS were independent predictors of outcome.
|Session name:||Abstracts 20th European Congress of Clinical Microbiology and Infectious Diseases|
|Location:||Vienna, Austria, 10 - 13 April 2010|
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