title: Angiopoietin-2 and outcome in patients with acute decompensated heart failure.
abstract: OBJECTIVE
  Angiopoietin-2 (Ang-2) impairs endothelial integrity. The association of Ang-2 in the presence of oedema and outcome of patients with acute decompensated heart failure (ADHF) has not been investigated.
  
  
  RESULTS
  Angiopoietin-2 was measured in 132 ADHF patients, which were included in a monocentric, prospective trial (Clinicaltrials.gov: NCT01429857). Primary endpoint was all-cause death at 6-months. 20 healthy persons served as control group (HC). In ADHF patients, mean Ang-2 concentration at admission was significantly increased compared to HC (2,111 ± 117 vs. 971 ± 46 pg/ml, p = 0.0002). Ang-2 was increased in patients with compared to those without peripheral oedema (2,294 ± 140 vs. 1,540 ± 170 pg/ml; p = 0.009) and in patients with NYHA class III or IV symptoms compared to those with NYHA class II symptoms (2,256 ± 132 vs. 1,341 ± 380 pg/ml, p = 0.023). During the 6-month follow-up, 10 patients died. In survivors, Ang-2 significantly decreased at discharge compared to admission (2,046 ± 118 vs. 1,431 ± 93 pg/ml; p < 0.0001). Non-survivors showed no difference between Ang-2 concentration at admission and discharge (3,296 ± 594 vs. 2,909 ± 536 pg/ml). Ang-2 concentrations at discharge above 2,500 pg/ml were associated with an increased risk of death compared to Ang-2 concentrations below this threshold (Hazard ratio 8.8; 95 % confidence interval; 2.48-31.16, p < 0.001).
  
  
  CONCLUSIONS
  In ADHF patients, Ang-2 is significantly increased compared to healthy controls, shows a relationship in the presence of oedema and is a predictor of poor outcome.
authors.affiliation: Klinik für Innere Medizin III, Universitätsklinikum des Saarlandes, 66421, Homburg/Saar, Germany, Janine.poess@uksh.de.
authors.forename: Janine
authors.initials: J
authors.lastname: Pöss
authors.forename: Christian
authors.initials: C
authors.lastname: Ukena
authors.forename: Ingrid
authors.initials: I
authors.lastname: Kindermann
authors.forename: Peter
authors.initials: P
authors.lastname: Ehrlich
authors.forename: Georg
authors.initials: G
authors.lastname: Fuernau
authors.forename: Sebastian
authors.initials: S
authors.lastname: Ewen
authors.forename: Felix
authors.initials: F
authors.lastname: Mahfoud
authors.forename: Steffen
authors.initials: S
authors.lastname: Kriechbaum
authors.forename: Michael
authors.initials: M
authors.lastname: Böhm
authors.forename: Andreas
authors.initials: A
authors.lastname: Link
mesh_terms: D000208:Acute Disease; D000368:Aged; D042702:Angiopoietin-2 / Q000097:blood* / Q000378:metabolism; D015415:Biomarkers / Q000097:blood; D015992:Body Mass Index; D055316:Cystatin C / Q000097:blood; D005260:Female; D005500:Follow-Up Studies; D005919:Glomerular Filtration Rate; D006333:Heart Failure / Q000097:blood* / Q000175:diagnosis* / Q000378:metabolism / Q000401:mortality; D006801:Humans; D007902:Length of Stay; D008297:Male; D008875:Middle Aged; D020097:Natriuretic Peptide, Brain / Q000097:blood; D010446:Peptide Fragments / Q000097:blood; D011237:Predictive Value of Tests; D011379:Prognosis; D011446:Prospective Studies; D012307:Risk Factors; D012680:Sensitivity and Specificity; D012720:Severity of Illness Index; D020107:Troponin T / Q000097:blood
chemical_list: D042702:Angiopoietin-2; D015415:Biomarkers; D055316:Cystatin C; D010446:Peptide Fragments; D020107:Troponin T; C109794:pro-brain natriuretic peptide (1-76); D020097:Natriuretic Peptide, Brain