Plasma adrenomedullin levels are associated with long-term outcomes of acute ischemic stroke

• Plasma adrenomedullin level increased in ischemic stroke.
• Adrenomedullin emerged as an independent predictor for 3-month clinical outcomes.
• Adrenomedullin had high prognostic performance for 3-month clinical outcomes.

Plasma adrenomedullin concentration has been found to be enhanced in ischemic stroke. Up to now, little is known about the association of plasma adrenomedullin concentration with clinical outcomes of ischemic stroke. This study recruited 138 patients with ischemic stroke and 138 healthy volunteers. Unfavorable outcome was defined as modified Rankin Scale score >2 at 3 months. Plasma adrenomedullin concentrations were determined by enzyme-linked immunosorbent assay. Plasma adrenomedullin concentrations were statistically significantly higher in patients than in healthy individuals (79.9 ± 27.3 pg/mL vs. 36.8 ± 10.4 pg/mL; P < 0.001). 3-Month mortality was 20.3% (28/138) and sixty-six patients (47.8%) had unfavorable outcome in 3 months. A logistic regression analysis identified plasma adrenomedullin concentration as an independent predictor of 3-month mortality (odds ratio, 1.211; 95% confidence interval, 1.101–1.582; P = 0.004) and unfavorable outcome (odds ratio, 1.193; 95% confidence interval, 1.082–1.447; P = 0.006). Receiver operating characteristic curve analysis showed that plasma adrenomedullin concentration predicted 3-month mortality (area under curve, 0.806; 95% confidence interval, 0.730–0.868) and unfavorable outcome (area under curve, 0.816; 95% confidence interval, 0.742–0.877) with the high predictive value. Its predictive performance was similar to that of National Institutes of Health Stroke Scale score (P = 0.694 or 0.206). Its combined use with National Institutes of Health Stroke Scale score did not improve the predictive value (P = 0.236 or 0.590). Thus, adrenomedullin may aid to predict long-term clinical outcomes of patients with ischemic stroke.