TY - JOUR
T1 - Early plasma angiopoietin-2 is prognostic for ARDS and mortality among critically ill patients with sepsis
AU - Rosenberger, Carrie M.
AU - Wick, Katherine D.
AU - Zhuo, Hanjing
AU - Wu, Nelson
AU - Chen, Yue
AU - Kapadia, Sharookh B.
AU - Guimaraes, Alessander
AU - Chang, Diana
AU - Choy, David F.
AU - Chen, Hubert
AU - Peck, Melicent
AU - Sullivan, Kathryn M.
AU - Ke, Serena
AU - Jauregui, Alejandra
AU - Leligdowicz, Aleksandra
AU - Sinha, Pratik
AU - Gomez, Antonio D.
AU - Kangelaris, Kirsten N.
AU - Delucchi, Kevin
AU - Liu, Kathleen D.
AU - Calfee, Carolyn S.
AU - Matthay, Michael A.
AU - Hendrickson, Carolyn M.
N1 - Publisher Copyright:
© 2023, The Author(s).
PY - 2023/12
Y1 - 2023/12
N2 - Angiopoietin-2 (Ang-2) is associated with vascular endothelial injury and permeability in the acute respiratory distress syndrome (ARDS) and sepsis. Elevated circulating Ang-2 levels may identify critically ill patients with distinct pathobiology amenable to targeted therapy. We hypothesized that plasma Ang-2 measured shortly after hospitalization among patients with sepsis would be associated with the development of ARDS and poor clinical outcomes. To test this hypothesis, we measured plasma Ang-2 in a cohort of 757 patients with sepsis, including 267 with ARDS, enrolled in the emergency department or early in their ICU course before the COVID-19 pandemic. Multivariable models were used to test the association of Ang-2 with the development of ARDS and 30-day morality. We found that early plasma Ang-2 in sepsis was associated with higher baseline severity of illness, the development of ARDS, and mortality risk. The association between Ang-2 and mortality was strongest among patients with ARDS and sepsis as compared to those with sepsis alone (OR 1.81 vs. 1.52 per log Ang-2 increase). These findings might inform models testing patient risk prediction and strengthen the evidence for Ang-2 as an appealing biomarker for patient selection for novel therapeutic agents to target vascular injury in sepsis and ARDS.
AB - Angiopoietin-2 (Ang-2) is associated with vascular endothelial injury and permeability in the acute respiratory distress syndrome (ARDS) and sepsis. Elevated circulating Ang-2 levels may identify critically ill patients with distinct pathobiology amenable to targeted therapy. We hypothesized that plasma Ang-2 measured shortly after hospitalization among patients with sepsis would be associated with the development of ARDS and poor clinical outcomes. To test this hypothesis, we measured plasma Ang-2 in a cohort of 757 patients with sepsis, including 267 with ARDS, enrolled in the emergency department or early in their ICU course before the COVID-19 pandemic. Multivariable models were used to test the association of Ang-2 with the development of ARDS and 30-day morality. We found that early plasma Ang-2 in sepsis was associated with higher baseline severity of illness, the development of ARDS, and mortality risk. The association between Ang-2 and mortality was strongest among patients with ARDS and sepsis as compared to those with sepsis alone (OR 1.81 vs. 1.52 per log Ang-2 increase). These findings might inform models testing patient risk prediction and strengthen the evidence for Ang-2 as an appealing biomarker for patient selection for novel therapeutic agents to target vascular injury in sepsis and ARDS.
UR - http://www.scopus.com/inward/record.url?scp=85161836313&partnerID=8YFLogxK
U2 - 10.1186/s13054-023-04525-3
DO - 10.1186/s13054-023-04525-3
M3 - Article
C2 - 37312169
AN - SCOPUS:85161836313
SN - 1364-8535
VL - 27
JO - Critical Care
JF - Critical Care
IS - 1
M1 - 234
ER -