학술논문
Early plasma angiopoietin-2 is prognostic for ARDS and mortality among critically ill patients with sepsis.
Document Type
article
Author
Rosenberger, Carrie M; Wick, Katherine D; Zhuo, Hanjing; Wu, Nelson; Chen, Yue; Kapadia, Sharookh B; Guimaraes, Alessander; Chang, Diana; Choy, David F; Chen, Hubert; Peck, Melicent; Sullivan, Kathryn M; Ke, Serena; Jauregui, Alejandra; Leligdowicz, Aleksandra; Sinha, Pratik; Gomez, Antonio D; Kangelaris, Kirsten N; Delucchi, Kevin; Liu, Kathleen D; Calfee, Carolyn S; Matthay, Michael A; Hendrickson, Carolyn M
Source
Critical care (London, England). 27(1)
Subject
Language
Abstract
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.