Circulating Angiopopietin-1 Correlates with the Clinical Course of Multiple Organ Dysfunction Syndrome and Mortality in Patients with Severe Sepsis

Shu Min Lin, Fu Tsai Chung, Chih Hsi Kuo, Pai Chien Chou, Tsai Yu Wang, Po Jui Chang, Yu Lun Lo, Chien Da Huang, Horng Chyuan Lin, Chun Hua Wang, Han Pin Kuo, Evert Eriksson.

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Abstract

To determine plasma concentrations of angiopoietin (Ang)- 1, Ang-2, Tie-2, and vascular endothelial growth factor (VEGF) in patients with sepsis-induced multiple organ dysfunction syndrome (MODS) and determine their association with mortality. The study prospectively recruited 96 consecutive patients with severe sepsis in a l intensive care unit of a tertiary hospital. Plasma Ang-1, Ang-2, Tie-2, and VEGF levels and MODS were determined in patients on days 1, 3, and 7 of sepsis. Univariate and Cox proportional hazards analysis were performed to develop a prognostic model. Days 1, 3, and 7 plasma Ang-1 concentrations were persistently decreased in MODS patients than in non-MODS patients (day1: 4.0±0.5 vs 8.0±0.5 ng/mL, P<0.0001; day 3, 3.2±0.6 vs 7.3±0.5 ng/mL, P<0.0001, day 7, 2.8±0.6 vs 10.4±0.7 ng/mL, P<0.0001). In patients with resolved MODS on day 7 of sepsis, Ang-1 levels were increased from day 1 (4.7±0.6 ng/mL vs 9.1±1.4 ng/mL, n=43, P=0.004). Plasma Ang-1 levels were lower in nonsurvivors than in survivors on days 1 (4.0±0.5 vs 7.1±0.5 ng/ mL, P<0.0001), 3 (3.8±0.6 vs 7.1±0.5 ng/mL, P<0.0001), and 7 (4.7±0.7 vs 11.0±0.8 ng/mL, P<0.0001) of severe sepsis. In contrast, plasma Ang-2 levels were higher in nonsurvivors than in survivors only on day 1 (15.8±2.0 vs 9.5±1.2 ng/mL, P=0.035). VEGF and Tie-2 levels were not associated with MODS and mortality. Ang-1 level less than the median value was the only independent predictor of mortality (hazard ratio, 2.57; 95% CI 1.12-5.90, P=0.025). Persistently decreased Ang-1 levels are associated with MODS and subsequently, mortality in patients with sepsis.

Original languageEnglish
Article numbere878
JournalMedicine (United States)
Volume94
Issue number20
DOIs
Publication statusPublished - Jan 1 2015

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Angiopoietin-1
Multiple Organ Failure
Sepsis
Angiopoietin-2
Mortality
Vascular Endothelial Growth Factor A
Survivors
Tertiary Care Centers
Intensive Care Units

ASJC Scopus subject areas

  • Medicine(all)

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Circulating Angiopopietin-1 Correlates with the Clinical Course of Multiple Organ Dysfunction Syndrome and Mortality in Patients with Severe Sepsis. / Lin, Shu Min; Chung, Fu Tsai; Kuo, Chih Hsi; Chou, Pai Chien; Wang, Tsai Yu; Chang, Po Jui; Lo, Yu Lun; Huang, Chien Da; Lin, Horng Chyuan; Wang, Chun Hua; Kuo, Han Pin; Eriksson., Evert.

In: Medicine (United States), Vol. 94, No. 20, e878, 01.01.2015.

Research output: Contribution to journalArticle

Lin, Shu Min ; Chung, Fu Tsai ; Kuo, Chih Hsi ; Chou, Pai Chien ; Wang, Tsai Yu ; Chang, Po Jui ; Lo, Yu Lun ; Huang, Chien Da ; Lin, Horng Chyuan ; Wang, Chun Hua ; Kuo, Han Pin ; Eriksson., Evert. / Circulating Angiopopietin-1 Correlates with the Clinical Course of Multiple Organ Dysfunction Syndrome and Mortality in Patients with Severe Sepsis. In: Medicine (United States). 2015 ; Vol. 94, No. 20.
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abstract = "To determine plasma concentrations of angiopoietin (Ang)- 1, Ang-2, Tie-2, and vascular endothelial growth factor (VEGF) in patients with sepsis-induced multiple organ dysfunction syndrome (MODS) and determine their association with mortality. The study prospectively recruited 96 consecutive patients with severe sepsis in a l intensive care unit of a tertiary hospital. Plasma Ang-1, Ang-2, Tie-2, and VEGF levels and MODS were determined in patients on days 1, 3, and 7 of sepsis. Univariate and Cox proportional hazards analysis were performed to develop a prognostic model. Days 1, 3, and 7 plasma Ang-1 concentrations were persistently decreased in MODS patients than in non-MODS patients (day1: 4.0±0.5 vs 8.0±0.5 ng/mL, P<0.0001; day 3, 3.2±0.6 vs 7.3±0.5 ng/mL, P<0.0001, day 7, 2.8±0.6 vs 10.4±0.7 ng/mL, P<0.0001). In patients with resolved MODS on day 7 of sepsis, Ang-1 levels were increased from day 1 (4.7±0.6 ng/mL vs 9.1±1.4 ng/mL, n=43, P=0.004). Plasma Ang-1 levels were lower in nonsurvivors than in survivors on days 1 (4.0±0.5 vs 7.1±0.5 ng/ mL, P<0.0001), 3 (3.8±0.6 vs 7.1±0.5 ng/mL, P<0.0001), and 7 (4.7±0.7 vs 11.0±0.8 ng/mL, P<0.0001) of severe sepsis. In contrast, plasma Ang-2 levels were higher in nonsurvivors than in survivors only on day 1 (15.8±2.0 vs 9.5±1.2 ng/mL, P=0.035). VEGF and Tie-2 levels were not associated with MODS and mortality. Ang-1 level less than the median value was the only independent predictor of mortality (hazard ratio, 2.57; 95{\%} CI 1.12-5.90, P=0.025). Persistently decreased Ang-1 levels are associated with MODS and subsequently, mortality in patients with sepsis.",
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AU - Kuo, Chih Hsi

AU - Chou, Pai Chien

AU - Wang, Tsai Yu

AU - Chang, Po Jui

AU - Lo, Yu Lun

AU - Huang, Chien Da

AU - Lin, Horng Chyuan

AU - Wang, Chun Hua

AU - Kuo, Han Pin

AU - Eriksson., Evert

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N2 - To determine plasma concentrations of angiopoietin (Ang)- 1, Ang-2, Tie-2, and vascular endothelial growth factor (VEGF) in patients with sepsis-induced multiple organ dysfunction syndrome (MODS) and determine their association with mortality. The study prospectively recruited 96 consecutive patients with severe sepsis in a l intensive care unit of a tertiary hospital. Plasma Ang-1, Ang-2, Tie-2, and VEGF levels and MODS were determined in patients on days 1, 3, and 7 of sepsis. Univariate and Cox proportional hazards analysis were performed to develop a prognostic model. Days 1, 3, and 7 plasma Ang-1 concentrations were persistently decreased in MODS patients than in non-MODS patients (day1: 4.0±0.5 vs 8.0±0.5 ng/mL, P<0.0001; day 3, 3.2±0.6 vs 7.3±0.5 ng/mL, P<0.0001, day 7, 2.8±0.6 vs 10.4±0.7 ng/mL, P<0.0001). In patients with resolved MODS on day 7 of sepsis, Ang-1 levels were increased from day 1 (4.7±0.6 ng/mL vs 9.1±1.4 ng/mL, n=43, P=0.004). Plasma Ang-1 levels were lower in nonsurvivors than in survivors on days 1 (4.0±0.5 vs 7.1±0.5 ng/ mL, P<0.0001), 3 (3.8±0.6 vs 7.1±0.5 ng/mL, P<0.0001), and 7 (4.7±0.7 vs 11.0±0.8 ng/mL, P<0.0001) of severe sepsis. In contrast, plasma Ang-2 levels were higher in nonsurvivors than in survivors only on day 1 (15.8±2.0 vs 9.5±1.2 ng/mL, P=0.035). VEGF and Tie-2 levels were not associated with MODS and mortality. Ang-1 level less than the median value was the only independent predictor of mortality (hazard ratio, 2.57; 95% CI 1.12-5.90, P=0.025). Persistently decreased Ang-1 levels are associated with MODS and subsequently, mortality in patients with sepsis.

AB - To determine plasma concentrations of angiopoietin (Ang)- 1, Ang-2, Tie-2, and vascular endothelial growth factor (VEGF) in patients with sepsis-induced multiple organ dysfunction syndrome (MODS) and determine their association with mortality. The study prospectively recruited 96 consecutive patients with severe sepsis in a l intensive care unit of a tertiary hospital. Plasma Ang-1, Ang-2, Tie-2, and VEGF levels and MODS were determined in patients on days 1, 3, and 7 of sepsis. Univariate and Cox proportional hazards analysis were performed to develop a prognostic model. Days 1, 3, and 7 plasma Ang-1 concentrations were persistently decreased in MODS patients than in non-MODS patients (day1: 4.0±0.5 vs 8.0±0.5 ng/mL, P<0.0001; day 3, 3.2±0.6 vs 7.3±0.5 ng/mL, P<0.0001, day 7, 2.8±0.6 vs 10.4±0.7 ng/mL, P<0.0001). In patients with resolved MODS on day 7 of sepsis, Ang-1 levels were increased from day 1 (4.7±0.6 ng/mL vs 9.1±1.4 ng/mL, n=43, P=0.004). Plasma Ang-1 levels were lower in nonsurvivors than in survivors on days 1 (4.0±0.5 vs 7.1±0.5 ng/ mL, P<0.0001), 3 (3.8±0.6 vs 7.1±0.5 ng/mL, P<0.0001), and 7 (4.7±0.7 vs 11.0±0.8 ng/mL, P<0.0001) of severe sepsis. In contrast, plasma Ang-2 levels were higher in nonsurvivors than in survivors only on day 1 (15.8±2.0 vs 9.5±1.2 ng/mL, P=0.035). VEGF and Tie-2 levels were not associated with MODS and mortality. Ang-1 level less than the median value was the only independent predictor of mortality (hazard ratio, 2.57; 95% CI 1.12-5.90, P=0.025). Persistently decreased Ang-1 levels are associated with MODS and subsequently, mortality in patients with sepsis.

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