Circulating angiopoietins and cardiovascular mortality in cardiogenic shock

Link, Andreas; Pöss, Janine; Rbah, Ranja; Barth, Christine; Feth, Luisa; Selejan, Simina; Böhm, Michael

doi:10.1093/eurheartj/ehs487

Cited by 46 publications

(44 citation statements)

References 45 publications

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“…However, this difference was much more pronounced and reached statistical significance only at the time of discharge. This finding is consistent with other investigations, which have also shown an association between the mortality and Ang-2 levels measured over time [13,17,23]. Importantly, we found a significant difference regarding the course of Ang-2 concentrations between admission and discharge with respect to mortality.…”

Section: Discussionsupporting

confidence: 93%

“…Its mediator Ang-2 promotes vascular leakage [5] and could be involved in oedema formation. In previous studies, we have shown a prognostic impact of Ang-2 in patients with cardiogenic shock (CS) [17]. Herein, we show that this also holds true for patients with ADHF.…”

Section: Discussionsupporting

confidence: 67%

“…Prior studies have described a prognostic role of Ang-2 and mortality in sepsis [11][12][13][21][22][23] as well as in cardiogenic shock [17]. In the present study, Ang-2 levels at admission were numerically elevated in non-survivors compared to survivors.…”

Section: Discussionsupporting

confidence: 51%

“…The cutoff value of 2,500 pg/ml was chosen since it was shown to be of prognostic relevance in CS [17] (Group 1: Ang-2_A \2,500 pg/ml; Ang-2_D \2,500 pg/ ml; group 2: Ang-2_A[2,500 pg/ml; Ang-2_D\2,500 pg/ ml: group 3: Ang-2_A[2,500 pg/ml; Ang-2_D[2,500 pg/ ml; group 4: Ang-2_A\2,500 pg/ml; Ang-2_D[2,500 pg/ ml). In the Kaplan-Meier analysis, patients with Ang-2 concentrations below 2,500 pg/ml at both time points had the best outcome whereas patients presenting with low Ang-2 at admission and increased Ang-2 at discharge had the worst prognosis, Fig.…”

Section: Ang-2 Concentrations and Outcomementioning

confidence: 99%

“…Furthermore, Ang-2 is an independent predictor for incident heart failure in patients with acute myocardial infarction [16]. Recently, we were able to show a strong prognostic role of Ang-2 in 96 patients with cardiogenic shock (CS) [17]. Beyond this background, our hypothesis was that Ang-2 might be involved in the pathophysiology of ADHF.…”

Section: Introductionmentioning

confidence: 97%

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Angiopoietin-2 and outcome in patients with acute decompensated heart failure

et al. 2014

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Section: Discussionsupporting

confidence: 93%

Section: Discussionsupporting

confidence: 67%

Section: Discussionsupporting

confidence: 51%

Section: Ang-2 Concentrations and Outcomementioning

confidence: 99%

Section: Introductionmentioning

confidence: 97%

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Angiopoietin-2 and outcome in patients with acute decompensated heart failure

et al. 2014

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Management of Cardiogenic Shock

Thiele¹,

Waha²

2017

Manual of STEMI Interventions

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Cardiogenic shock (CS) remains the most common cause of death in patients with acute myocardial infarction although mortality could be reduced from formerly 80% to 40-50%. In addition to percutaneous coronary intervention or coronary artery bypass grafting, catecholamines, fluids, intraaortic balloon pumping (IABP), and also active assist devices are widely used for CS management. However, there is only limited evidence for any of the above treatments except for early revascularization and the relative ineffectiveness of IABP. This updated review will therefore outline the management of CS complicating acute myocardial infarction with major focus on evidence-based revascularization techniques, intensive care unit treatment including ventilation, transfusion regimens, adjunctive medication, and mechanical support devices.

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Growth‐differentiation factor 15 and osteoprotegerin in acute myocardial infarction complicated by cardiogenic shock: a biomarker substudy of the IABP‐SHOCK II‐trial

Fuernau

Poenisch

Eitel

et al. 2014

European J of Heart Fail

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Aims This study investigates the role of osteoprotegerin (OPG) and growth‐differentiation factor 15 (GDF‐15) as predictors of outcome in cardiogenic shock (CS) complicating acute myocardial infarction. The novel biomarkers OPG and GDF‐15 have shown prognostic impact in various cardiovascular diseases including myocardial infarction. In acute myocardial infarction complicated by CS, the diagnostic and prognostic impact of these biomarkers has not been investigated yet. OPG and GDF‐15 may have additional prognostic impact on early prognosis assessment, being potentially useful for decision‐making in CS. Methods and results In the randomized Intra‐aortic Balloon Pump in cardiogenic Shock II (IABP‐SHOCK II)‐trial, 600 patients with CS complicating acute myocardial infarction undergoing early revascularization were assigned to therapy with or without IABP. Within a pre‐defined substudy, blood samples were collected from 190 patients during PCI. GDF‐15 and OPG serum levels were measured with standard enzyme‐linked immunosorbent assay kits. Patients with GDF‐15 and OPG levels greater than the median showed higher rates of death at 30 days by χ2 testing (OPG, 51% vs. 32%, P = 0.01; GDF‐15, 52% vs. 31%, P = 0.005) and log rank testing [GDF‐15, hazard ratio (HR) 1.88, 95% confidence interval (CI) 1.21–2.94; P = 0.005; OPG, HR 1.74, 95% CI 1.11–2.71; P = 0.01]. Both markers were significantly predictive of 30‐day mortality in univariable logistic regression analysis. In a multivariable logistic stepwise regression model, GDF‐15, TIMI (Thrombolysis In Myocardial Infarction) flow grade <3 after PCI, age, LVEF, and serum lactate remained significant predictors of 30‐day mortality. Conclusion GDF‐15 on admission is a significant independent predictor of short‐term mortality in infarct‐related CS. Trail registration: NCT00491036

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Circulating angiopoietins and cardiovascular mortality in cardiogenic shock

Cited by 46 publications

References 45 publications

Angiopoietin-2 and outcome in patients with acute decompensated heart failure

Angiopoietin-2 and outcome in patients with acute decompensated heart failure

Management of Cardiogenic Shock

Growth‐differentiation factor 15 and osteoprotegerin in acute myocardial infarction complicated by cardiogenic shock: a biomarker substudy of the IABP‐SHOCK II‐trial

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