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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ASJC Scopus subject areas

  • Medicine(all)

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