Role of serum activin-A in ARDS patients

Abstract

Background: There are limited data regarding serum activin-A as a biomarker for ARDS. We aimed to evaluate whether serum activin-A levels are elevated and it has any role in predicting severity and prognosis in ARDS patients. Methods: Retrospective cohort study was performed with patients who were admitted to MICU with diagnosis of ARDS and have serum samples stored within 48 hours of ICU admission between March 2013 and December 2016 at a single tertiary referral hospital. Serum activin-A levels were measured with ELISA kit, and were ii compared with those of normal healthy control and non-ARDS sepsis patients. Results: Serum activin-A levels of total 97 patients with ARDS were measured. Levels of Activin-A were elevated in ARDS patients compared to those of healthy controls (2.34 vs. 2.89, p<0.001) and non-ARDS sepsis patients (2.73 vs. 2.89, p=0.002). Activin-A was not correlated with severity of ARDS at the time of ICU admission, but showed statistically significant correlation with in-hospital mortalities (Inhospital survivors 676.2 vs. non-survivors 897.9, p=0.047). In predicting inhospital mortality, serum activin-A concentrations showed superior AUC compared to that of APACHE II scores (0.653

95% CI [0541, 0.765] vs. 0.591, 95% CI [0.471, 0.710]). With cut-off level of 708pg/mL, those with high serum activin-A levels had more than twofold increased risk of in-hospital mortalities. Conclusions: Serum activin-A levels in ARDS patients are elevated. Those with high serum activin-A levels tend to have poor prognosis.