@article {DaianaP564, author = {Stolz Daiana and Anja Meyer and Janko Rakic and Lucas Boeck and Andreas Scherr and Michael Tamm}, title = {Mortality risk prediction in COPD by a prognostic biomarker panel {\textendash} Results of a derivation and validation cohort with a long term follow-up}, volume = {44}, number = {Suppl 58}, elocation-id = {P564}, year = {2014}, publisher = {European Respiratory Society}, abstract = {Background: COPD is a complex disease with varying phenotypes. The simultaneous determination of multiple biomarkers reflecting different pathobiologic pathways could be useful in identifying individuals with increased risk of death in COPD.Objective: To derive and validate the combination of three plasma biomarkers to estimate mortality risk in COPD.Methods: Prospective cohort study including 385 patients with a follow-up of 5 years. Baseline levels of adrenomedullin, arginine-vasopressin, and atrial natriuretic peptide were measured in subjects at a time when they were not experiencing symptoms of exacerbation. Biomarkers were analyzed in combination defined as high or low according to cut points.Results: In the derivation cohort (n=142), there were 73 deaths. Crude hazard ratios for mortality were 3.0 (95\%CI 1.8-5.1) for 1 high biomarker, 4.8 (95\%CI 2.4-9.5) for 2 biomarkers and 9.6 (95\%CI 3.3-28.3) for 3 high biomarkers compared with no elevated biomarkers. In the validation cohort (n=243), 87 individuals died. Corresponding hazard ratios were 1.9 (95\%CI 1.1-3.3), 3.1 (95\%CI 1.8-5.4) and 5.4 (95\%CI 2.5-11.4). Multivariable adjustment for clinical variables as well as the BODE-index and stratification by the GOLD stages provided consistent results. The addition of the panel to the BODE-index generated a net reclassification improvement of 57.9\% (95\%CI 21.7\%-92.4\%) at 3 years follow-up and 45.9\% (95\%CI 13.9\%-75.7\%) at 5 years follow-up.Conclusions: Simultaneously elevated levels of adrenomedullin, arginine vasopressin and atrial natriuretic peptide are associated with increased risk of death in patients with stable COPD.}, issn = {0903-1936}, URL = {https://erj.ersjournals.com/content/44/Suppl_58/P564}, eprint = {https://erj.ersjournals.com/content}, journal = {European Respiratory Journal} }