Association of midregional proadrenomedullin with coronary artery stenoses, soft atherosclerotic plaques and coronary artery calcium

Midregional proadrenomedullin (MR-proADM) is elevated in patients with heart failure and myocardial infarction. The aim of this study was to evaluate the association of MR-proADM with the grade of coronary artery stenosis, presence of coronary artery soft plaques and coronary artery calcification score (CACS), determined by 64-multislice computed tomography (MSCT) in patients without known prior cardiovascular disease. This retrospective study included 107 patients undergoing MSCT for confirmation (or exclusion) of coronary artery disease. MR-proADM levels were measured in all patients. The assessment of coronary artery stenoses, CACS and soft coronary plaques was made by MSCT using known criteria. The MR-proADM [median (25th–75th percentiles)] level was 0.33 (0.21–0.43)?nmol/l. The MR-proADM level was 0.28 (0.22–0.40)?nmol/l in patients with coronary stenoses ≥50% (n?=?23) versus 0.33 (0.27–0.40)?nmol/l in patients with coronary stenoses <50% (n?=?83, P?=?0.59), 0.33 (0.26–0.40)?nmol/l in patients with soft plaques (n?=?56) versus 0.33 (0.25–0.41)?nmol/l in patients without soft plaques (n?=?50, P?=?0.73) and 0.33 (0.25–0.39)?nmol/l in patients with CACS?<200 (n?=?81) versus 0.32 (0.26–0.44)?nmol/l in patients with CACS?≥200 (n?=?26, P?=?0.77). In multivariate analysis, the MR-proADM level was a significant correlate of coronary artery stenoses [odds ratio (OR)?=?0.93; 95% confidence interval (CI) 0.86–0.99; P?=?0.026] and soft plaques (OR?=?0.94; 95% CI 0.90–0.99; P?=?0.015) but not of CACS (OR?=?0.98; 95% CI 0.93–1.03; P?=?0.36). A decreased MR-proADM level is an independent correlate of the presence of coronary artery disease and of soft atherosclerotic plaques. Patients with decreased MR-proADM levels may need invasive examinations to diagnose more severe forms of coronary artery disease.