Background: Cardiovascular complications, including myocardial infarction and chronic heart failure, remain the leading causes of morbidity and mortality worldwide. Identifying biomarkers that could improve risk stratification is an ongoing clinical challenge. Mid-regional pro-adrenomedullin (MR-proADM), a stable fragment of adrenomedullin, has been proposed as a marker of endothelial dysfunction and adverse cardiovascular outcomes. The aim of this study was to evaluate MR-proADM concentrations in relation to cardiovascular complications in patients with and without COVID-19.

Methods: A total of 157 patients were enrolled, including 66 with cardiovascular disease (CVD) and COVID-19, 74 with CVD but no history of COVID-19, and 17 without either condition. Plasma MR-proADM levels were measured, and the frequency of chronic heart failure and myocardial infarction was compared between patients with low versus high MR-proADM concentrations (cut-off: median). Logistic regression models were used to explore predictive value.

Results: Median MR-proADM levels did not differ significantly between patients with or without COVID-19. Similarly, no significant differences in the frequency of chronic heart failure (55.0% vs. 54.5%) or myocardial infarction (11.3% vs. 20.8%) were observed between patients with low and high MR-proADM. Logistic regression confirmed that MR-proADM was not a significant predictor of either complication.

Conclusions: In this cohort, MR-proADM did not provide incremental prognostic value for predicting cardiovascular complications such as heart failure or myocardial infarction. These findings highlight the complexity of biomarker interpretation in multimorbid populations and emphasize the need for larger, prospective studies to define the clinical role of MR-proADM in cardiovascular risk stratification.

Paulina Pietraszko is a PhD student at the Medical University of Bialystok, Poland, in the Department of Internal Medicine and Hypertension. Her research focuses on cardiovascular risk stratification and the role of novel biomarkers, particularly in the context of COVID-19 and chronic cardiovascular diseases. She combines clinical experience with academic research, aiming to translate biomarker discoveries into practical diagnostic tools for everyday clinical practice.