Document Detail


Ratio of angiopoietin-2 to angiopoietin-1 as a predictor of mortality in acute lung injury patients.
MedLine Citation:
PMID:  20581666     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
OBJECTIVE: To test the hypothesis that the concentration of angiopoietin-2 relative to angiopoietin-1 may be a useful biological marker of mortality in acute lung injury patients. We also tested the association of concentration of angiopoietin-2 relative to angiopoietin-1 with physiologic and biological markers of activated endothelium.
DESIGN: Prospective, observational cohort study.
SETTING: Intensive care units in a tertiary care university hospital and a university-affiliated city hospital.
PATIENTS: Fifty-six mechanically ventilated patients with acute lung injury.
INTERVENTIONS: Baseline plasma samples and pulmonary dead-space fraction measurements were collected within 48 hrs of acute lung injury diagnosis.
MEASUREMENTS AND MAIN RESULTS: Plasma levels of angiopoietin-1 and angiopoietin-2 and of biomarkers of endothelial activation were measured by enzyme-linked immunosorbent assay. Baseline concentration of angiopoietin-2 relative to angiopoietin-1 was significantly higher in patients who died (median, 58 [interquartile range, 17-117] vs. 14 [interquartile range, 6-35]; p = .01). In a multivariable analysis stratified by dead-space fraction, concentration of angiopoietin-2 relative to angiopoietin-1 was an independent predictor of death, with an adjusted odds ratio of 4.3 (95% confidence interval, 1.3-13.5; p = .01) in those with an elevated pulmonary dead-space fraction (p = .03 for interaction between pulmonary dead-space fraction and concentration of angiopoietin-2 relative to angiopoietin-1). Moderate to weak correlation was found with biological markers of endothelial activation.
CONCLUSIONS: The ratio of concentration of angiopoietin-2 relative to angiopoietin-1 may be a prognostic biomarker of endothelial activation in acute lung injury patients and, along with pulmonary dead-space fraction, may be useful for risk stratification of acute lung injury patients, particularly in identifying subgroups for future research and therapeutic trials.
Authors:
Thida Ong; Dana E McClintock; Richard H Kallet; Lorraine B Ware; Michael A Matthay; Kathleen D Liu
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Publication Detail:
Type:  Journal Article; Research Support, N.I.H., Extramural    
Journal Detail:
Title:  Critical care medicine     Volume:  38     ISSN:  1530-0293     ISO Abbreviation:  Crit. Care Med.     Publication Date:  2010 Sep 
Date Detail:
Created Date:  2010-08-20     Completed Date:  2010-09-27     Revised Date:  2014-04-08    
Medline Journal Info:
Nlm Unique ID:  0355501     Medline TA:  Crit Care Med     Country:  United States    
Other Details:
Languages:  eng     Pagination:  1845-51     Citation Subset:  AIM; IM    
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MeSH Terms
Descriptor/Qualifier:
Acute Lung Injury / blood,  mortality*
Adult
Angiopoietin-1 / blood*
Angiopoietin-2 / blood*
Biological Markers / blood*
Enzyme-Linked Immunosorbent Assay
Female
Humans
Male
Middle Aged
Multivariate Analysis
Prognosis
Prospective Studies
Grant Support
ID/Acronym/Agency:
HL081332/HL/NHLBI NIH HHS; HL51856/HL/NHLBI NIH HHS; HR046059/HR/NHLBI NIH HHS; KL2RR024130/RR/NCRR NIH HHS; R37 HL051856/HL/NHLBI NIH HHS; U01 HL081332/HL/NHLBI NIH HHS
Chemical
Reg. No./Substance:
0/ANGPT1 protein, human; 0/Angiopoietin-1; 0/Angiopoietin-2; 0/Biological Markers

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


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