Angiopoietin-2 and angiopoietin-like 4 protein provide prognostic information in patients with suspected acute coronary syndrome.

Abstract

BACKGROUND:

Plasma levels of angiopoietin-2 (ANGPT2) and angiopoietin-like 4 protein (ANGPTL4) reflect different pathophysiological aspects of cardiovascular disease. We evaluated their association with outcome in a hospitalized Norwegian patient cohort (n = 871) with suspected acute coronary syndrome (ACS) and validated our results in a similar Argentinean cohort (n = 982).

METHODS:

A cox regression model, adjusting for traditional cardiovascular risk factors, was fitted for ANGPT2 and ANGPTL4, respectively, with all-cause mortality and cardiac death within 24 months and all-cause mortality within 60 months as the dependent variables.

RESULTS:

At 24 months follow-up, 138 (15.8%) of the Norwegian and 119 (12.1%) of the Argentinian cohort had died, of which 86 and 66 deaths, respectively, were classified as cardiac. At 60 months, a total of 259 (29.7%) and 173 (17.6%) patients, respectively, had died. ANGPT2 was independently associated with all-cause mortality in both cohorts at 24 months [hazard ratio (HR) 1.27 (95% confidence interval (CI), 1.08-1.50) for Norway, and HR 1.57 (95% CI, 1.27-1.95) for Argentina], with similar results at 60 months [HR 1.19 (95% CI, 1.05-1.35) (Norway), and HR 1.56 (95% CI, 1.30-1.88) (Argentina)], and was also significantly associated with cardiac death [HR 1.51 (95% CI, 1.14-2.00)], in the Argentinean population. ANGPTL4 was significantly associated with all-cause mortality in the Argentinean cohort at 24 months [HR 1.39 (95% CI, 1.15-1.68)] and at 60 months [HR 1.43 (95% CI, 1.23-1.67)], enforcing trends in the Norwegian population.

CONCLUSIONS:

ANGPT2 and ANGPTL4 were significantly associated with outcome in similar ACS patient cohorts recruited on two continents.

CLINICAL TRIAL REGISTRATION:

ClinicalTrials.gov Identifier: NCT00521976. ClinicalTrials.gov Identifier: NCT01377402.

• Authors: Reidun Aarsetøy, Thor Ueland, Pål Aukrust, Annika E Michelsen, Ricardo Leon de la Fuente, Volker Pönitz, Trygve Brügger-Andersen, Heidi Grundt, Harry Staines, Dennis W T Nilsen
• Journal: Journal of internal medicine (J Intern Med) Vol. 290 Issue 4 Pg. 894-909 (10 2021) ISSN: 1365-2796 [Electronic] England
• PMID: 34237166 (Publication Type: Journal Article, Observational Study)
• Copyright: © 2021 The Authors. Journal of Internal Medicine published by John Wiley & Sons Ltd on behalf of Association for Publication of The Journal of Internal Medicine.

Chemical References

• ANGPT2 protein, human
• ANGPTL4 protein, human
• Angiopoietin-2
• Angiopoietin-Like Protein 4

Topics

• Acute Coronary Syndrome (diagnosis, mortality)
• Angiopoietin-2 (blood)
• Angiopoietin-Like Protein 4 (blood)
• Argentina (epidemiology)
• Humans
• Norway (epidemiology)
• Prognosis
• Proportional Hazards Models