Author + information
C-terminal provasopressin (copeptin), mid-regional pro-atrial natriuretic peptide (MR-proANP), and mid-regional pro-adrenomedullin (MR-proADM) are novel cardiac biomarkers associated with patients' prognosis in heart failure, stable ischemic disease, and acute coronary syndrome. We aimed to evaluate the inner correlation between these 3 biomarkers, their association with clinical phenotypes of coronary artery disease, and the risk of type 2 diabetes mellitus (T2DM) in the Chinese Han population.
The study included 262 patients with coronary artery disease, including 27 with old myocardial infarction, 55 with acute myocardial infarction, and 180 with stable coronary artery disease. Controls included 130 subjects without coronary artery disease. These 3 biomarkers copeptin, MR-proANP, and MR-proADM were determined by ELISA kits. Pearson’s correlation coefficient was calculated to test the associations between the 3 biomarkers and the primary continuous variables. Multivariable logistic regression analysis was performed to identify the predictive factors of T2DM.
Patients with coronary artery disease and non-coronary artery disease controls had similar values of copeptin, MR-proANP, and MR-proADM. Compared with controls and those with stable angina pectoris, subjects with old myocardial infarction and acute myocardial infarction had higher levels of copeptin and MR-proADM (all P<0.05); the group with old myocardial infarction had the highest and the group with acute myocardial infarction had the lowest MR-proANP (all P<0.05). Copeptin, MR-proANP, and MR-proADM were positively correlated with each other, and furthermore, MR-proANP was positively correlated with hemoglobin and total bilirubin. Compared with subjects without T2DM, those with T2DM had higher values of copeptin and heart rate, a higher ratio of old myocardial infarction and acute myocardial infarction, and lower values of MR-proADM. Patients with and without T2DM had similar levels of MR-proANP. Multivariable regression analysis identified copeptin (OR: 1.107, 95% CI: 1.017-1.205, P=0.018), MR-proADM (OR: 0.940, 95% CI: 0.902-0.980, P=0.003), and triglycerides (OR: 1.526, 95% CI: 1.193-1.952, P=0.001) as predictors of T2DM.
The novel cardiac biomarkers copeptin, MR-proANP, and MR-proADM are internally related and are associated with clinical phenotypes of coronary artery disease and risk of diabetes in the Chinese Han population.