Document Detail

Circulating angiopoietins and cardiovascular mortality in cardiogenic shock.
MedLine Citation:
PMID:  23349297     Owner:  NLM     Status:  Publisher    
AimsVascular integrity is disturbed in shock contributing to clinical appearance and serious outcomes. While angiopoietin (Ang)-1 protects from vascular inflammation and leakage, Ang-2 disrupts endothelial barrier function. The imbalance of Ang-1 and Ang-2, their association to haemodynamic deterioration, and their prognostic relevance are not known and, thus, were prospectively evaluated in patients with cardiogenic shock (CS) in this study.Methods and resultsPlasma Ang-1 and Ang-2 were determined by the enzyme immunoassay in patients with CS (n = 96), uncomplicated acute myocardial infarction (AMI, n = 20) and age-matched healthy controls (HC, n = 20). Angiopoietin-2 was three-fold elevated in CS compared with HC (P < 0.001), remained elevated in non-survivors, and decreased in survivors (P < 0.001). In contrast, Ang-1 decreased up to 35-fold in CS (P < 0.001). Angiopoietin-1 was correlated and Ang-2 was inversely related to a cardiac power index and mixed venous oxygen saturation, respectively (P < 0.001 for all). To assess the prognostic relevance, two outcome variables were considered: the 28-day mortality and the survival time (follow-up time 1 year). For Ang-2 at admission a cut-off point of 2500 pg/mL had a sensitivity of 61% and a specificity of 80% to determine 28-day mortality in CS (confirmed by receiver operating characteristic analysis, area under the curve = 0.71 ± 0.06, P < 0.001). Angiopoietin-2 levels >2500 pg/mL at admission were observed to be an independent predictor for 1-year mortality in CS confirmed by Cox proportional hazard analysis [hazard ratio (HR) 2.11; 95% confidence interval (CI) 1.03-4.36; P = 0.042].ConclusionCirculating Angs are closely related to outcome and severity in CS. Angiopoietin-2 emerged as an independent predictor of 28-day and 1-year mortality in CS. Larger studies are required to define the cut-off and predictive values for Ang-2. Angiopoietins may be prognostic biomarkers for survival in CS and might represent a novel therapeutic target.
Andreas Link; Janine Pöss; Ranja Rbah; Christine Barth; Luisa Feth; Simina Selejan; Michael Böhm
Related Documents :
23465417 - Complete versus culprit-only revascularization during primary percutaneous coronary int...
10767067 - Free-breathing 3d coronary mra: the impact of "isotropic" image resolution.
23305237 - Programmed versus effective vv delay during crt optimization: when what you see is not ...
23988677 - Do depressive symptoms predict the incidence of myocardial infarction independent of ho...
21615317 - Does remote ischemic conditioning salvage left ventricular function after successful pr...
21527187 - Alcohol drinking triggers acute myocardial infarction in a case of hypertrophic obstruc...
Publication Detail:
Type:  JOURNAL ARTICLE     Date:  2013-1-24
Journal Detail:
Title:  European heart journal     Volume:  -     ISSN:  1522-9645     ISO Abbreviation:  Eur. Heart J.     Publication Date:  2013 Jan 
Date Detail:
Created Date:  2013-1-25     Completed Date:  -     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  8006263     Medline TA:  Eur Heart J     Country:  -    
Other Details:
Languages:  ENG     Pagination:  -     Citation Subset:  -    
Klinik für Innere Medizin III, Universitätsklinikum des Saarlandes, Homburg/Saar D-66421, Germany.
Export Citation:
APA/MLA Format     Download EndNote     Download BibTex
MeSH Terms

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine

Previous Document:  Prevention of contrast-induced nephropathy with Na/K citrate.
Next Document:  Oral Creatine Supplementation Augments the Repeated Bout Effect.