Vasostatin-I, a chromogranin A-derived peptide, in non-selected critically ill patients: distribution, kinetics, and prognostic significance

Purpose

Chromogranin A (CGA) is released in the plasma during life-threatening illnesses. Its N-terminal 1–76 peptide, vasostatin-I (VS-I), has never been assessed in critically ill patients. Our aim was to examine whether the admission VS-I concentration has prognostic significance without having to specify a primary diagnosis.

Methods

VS-I concentrations were assessed with a new ELISA in 481 consecutive patients and 13 healthy controls. CGA and standard biological tests (including lactate) were performed; the simplified acute physiological score II (SAPS II) was calculated. Mortality was assessed at day 28. In a subgroup of 13 patients with shock, serial VS-I doses were given over 60?h.

Results

Critically ill patients had higher admission VS-I concentrations than controls 4.06 (2.78; 7.61) vs. 2.85 (2.47; 3.22)?ng/ml, p?p?p?p?p?Conclusions Significant amounts of VS-I are detected on admission in critically ill patients. A plasma VS-I concentration above 3.97?ng/ml is associated with poor outcome, and in routine practice simultaneous measurements of the three independent factors VS-I, lactate and age can affect the assessment of severity.