| Ratio of angiopoietin-2 to angiopoietin-1 as a predictor of mortality in acute lung injury patients. | |
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MedLine Citation:
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PMID: 20581666 Owner: NLM Status: MEDLINE |
Abstract/OtherAbstract:
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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. |
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Authors:
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Thida Ong; Dana E McClintock; Richard H Kallet; Lorraine B Ware; Michael A Matthay; Kathleen D Liu |
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Publication Detail:
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Type: Journal Article; Research Support, N.I.H., Extramural |
Journal Detail:
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Title: Critical care medicine Volume: 38 ISSN: 1530-0293 ISO Abbreviation: Crit. Care Med. Publication Date: 2010 Sep |
Date Detail:
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Created Date: 2010-08-20 Completed Date: 2010-09-27 Revised Date: - |
Medline Journal Info:
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Nlm Unique ID: 0355501 Medline TA: Crit Care Med Country: United States |
Other Details:
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Languages: eng Pagination: 1845-51 Citation Subset: AIM; IM |
Affiliation:
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Division of Pulmonary Medicine, Department of Pediatrics, University of California, San Francisco, California, USA. |
Export Citation:
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| MeSH Terms | |
Descriptor/Qualifier:
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Acute Lung Injury
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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:
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HL081332/HL/NHLBI NIH HHS; HL51856/HL/NHLBI NIH HHS; HR046059/HR/NHLBI NIH HHS; KL2RR024130/RR/NCRR NIH HHS |
| Chemical | |
Reg. No./Substance:
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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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