Abstract | INTRODUCTION: METHODS: A total of 52 resuscitated patients were divided into two subgroups: 23 survivors and 29 non-survivors. The serum levels of VEGF, soluble VEGF receptor (sVEGFR)1, sVEGFR2, Ang1, Ang2 and soluble Tie2 (sTie2) were measured at the time of admission (Day 1) and on Day 3 and Day 5. The ratio of Ang2 to Ang1 (Ang2/Ang1) was also calculated. This study compared the levels of angiogenic factors and their soluble receptors between survivors and non-survivors, and evaluated the predictive value of these factors for organ dysfunction and 28-day mortality. RESULTS: The non-survivors demonstrated more severe degrees of organ dysfunction and a higher prevalence of MODS. Non-survivors showed significant increases in the Ang2 levels and the Ang2/Ang1 ratios compared to survivors. A stepwise logistic regression analysis demonstrated that the Ang2 levels or the Ang2/Ang1 ratios on Day 1 independently predicted the 28-day mortality. The receiver operating characteristic curves of the Ang2 levels, and the Ang2/Ang1 ratios on Day 1 were good predictors of 28-day mortality. The Ang2 levels also independently predicted increases in the Sequential Organ Failure Assessment (SOFA) scores. CONCLUSIONS: We observed a marked imbalance between Ang1 and Ang2 in favor of Ang2 in PCAS patients, and the effect was more prominent in non-survivors. Angiogenic factors and their soluble receptors, particularly Ang2 and Ang2/Ang1, are considered to be valuable predictive biomarkers in the development of organ dysfunction and poor outcomes in PCAS patients.
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Authors | Takeshi Wada, Subrina Jesmin, Satoshi Gando, Yuichiro Yanagida, Asumi Mizugaki, Sayeeda N Sultana, Sohel Zaedi, Hiroyuki Yokota |
Journal | Critical care (London, England)
(Crit Care)
Vol. 16
Issue 5
Pg. R171
(Sep 29 2012)
ISSN: 1466-609X [Electronic] England |
PMID | 23021336
(Publication Type: Journal Article, Research Support, Non-U.S. Gov't)
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Chemical References |
- Receptor, Angiotensin, Type 1
- Receptor, Angiotensin, Type 2
- VEGFA protein, human
- Vascular Endothelial Growth Factor A
- Angiotensin II
- Angiotensin I
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Topics |
- Aged
- Angiotensin I
(blood)
- Angiotensin II
(blood)
- Female
- Heart Arrest
(blood, diagnosis, mortality)
- Humans
- Male
- Middle Aged
- Mortality
(trends)
- Multiple Organ Failure
(blood, diagnosis, mortality)
- Predictive Value of Tests
- Receptor, Angiotensin, Type 1
(blood)
- Receptor, Angiotensin, Type 2
(blood)
- Syndrome
- Vascular Endothelial Growth Factor A
(blood)
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