Diagnostic and Prognostic Value of Adrenomedullin in Acute Ischemic and Hemorrhagic Strokes: A Systematic Review and Meta-Analysis.

BACKGROUND: Early detection and outcome prediction of stroke are crucial for enhancing poststroke care. We explored the diagnostic and prognostic potential of bioactive adrenomedullin (bio-ADM) in stroke through a systematic review and meta-analysis. METHODS: Medline, Embase, Scopus, and Web of Science were searched for studies measuring bio-ADM in patients with stroke. Diagnostic outcomes were confirmed via imaging, while prognostic outcomes included mortality and modified Rankin Scale (mRS). For meta-analysis, standardized mean differences (SMDs), pooled odds ratios (ORs), and sensitivity/specificity were synthesized. RESULTS: =0.135). Sensitivity and specificity for mortality prediction were 0.617 (95% CI: 0.516-0.709) and 0.850 (95% CI: 0.772-0.905), respectively. Bio-ADM levels were also higher in patients with mRS score of 3 to 6 compared to those with mRS score of 0 to 2 (SMD: 0.48; 95% CI: 0.16-0.80). CONCLUSION: Bio-ADM is significantly elevated in both hemorrhagic and ischemic strokes and associated with mortality and poor outcomes, though it is not independently predictive of death.