Abstract | INTRODUCTION: METHODS: RESULTS: Plasma kallistatin was significantly consumed in severe CAP patients compared with healthy individuals. Lower day 1 kallistatin levels showed a strong trend toward increased mortality (P = 0.018) and higher day 1 CURB-65 scores (P = 0.004). Plasma kallistatin levels on day 1 of ICU admission were significantly decreased in patients who developed septic shock (P = 0.017) and who had acute respiratory distress syndrome (P = 0.044). In addition, kallistatin levels were positively correlated with anti- thrombin III and protein C and inversely correlated with IL-1β, IL-6, and CRP levels. In a multivariate logistic regression analysis, higher day 1 CURB-65 scores were independent predictors of mortality (odds ratio = 29.9; P = 0.009). Also, higher day 1 kallistatin levels were independently associated with a decreased risk of death (odds ratio, 0.1) with a nearly significant statistical difference (P = 0.056). Furthermore, we found that a cutoff level of 6.5 μg/ml of day 1 kallistatin determined by receiver operating characteristic curves could be used to distinguish between patients who survived in 60 days and those who did not. CONCLUSIONS: These results suggest that kallistatin may serve as a novel marker for severe CAP prognosis and may be involved in the pathogenesis of CAP through antiinflammatory and anticoagulation effects.
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Authors | Wei-Chieh Lin, Shiou-Ling Lu, Chiou-Feng Lin, Chang-Wen Chen, Lee Chao, Julie Chao, Yee-Shin Lin |
Journal | Critical care (London, England)
(Crit Care)
Vol. 17
Issue 1
Pg. R27
(Feb 08 2013)
ISSN: 1466-609X [Electronic] England |
PMID | 23394256
(Publication Type: Journal Article, Observational Study, Research Support, Non-U.S. Gov't)
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Chemical References |
- Biomarkers
- Serpins
- kallistatin
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Topics |
- Adult
- Aged
- Aged, 80 and over
- Biomarkers
(blood)
- Community-Acquired Infections
(blood, diagnosis, mortality)
- Female
- Humans
- Male
- Middle Aged
- Mortality
(trends)
- Pneumonia
(blood, diagnosis, mortality)
- Prospective Studies
- Serpins
(blood)
- Severity of Illness Index
- Young Adult
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