Format

Send to

Choose Destination
See comment in PubMed Commons below
Crit Care Med. 2010 Sep;38(9):1845-51. doi: 10.1097/CCM.0b013e3181eaa5bf.

Ratio of angiopoietin-2 to angiopoietin-1 as a predictor of mortality in acute lung injury patients.

Author information

1
Division of Pulmonary Medicine, Department of Pediatrics, University of California, San Francisco, California, USA.

Abstract

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.

PMID:
20581666
PMCID:
PMC4009623
DOI:
10.1097/CCM.0b013e3181eaa5bf
[Indexed for MEDLINE]
Free PMC Article
PubMed Commons home

PubMed Commons

0 comments
How to join PubMed Commons

    Supplemental Content

    Full text links

    Icon for Lippincott Williams & Wilkins Icon for PubMed Central
    Loading ...
    Support Center