title: Serum Concentrations of Angiopoietin-2 and Soluble fms-Like Tyrosine Kinase 1 (sFlt-1) Are Associated with Coagulopathy among Patients with Acute Pancreatitis.
abstract: In severe acute pancreatitis (SAP), systemic inflammation leads to endothelial dysfunction and activation of coagulation. Thrombotic disorders in acute pancreatitis (AP) include disseminated intravascular coagulation (DIC). Recently, angiopoietin-2 and soluble fms-like tyrosine kinase 1 (sFlt-1) were proposed as markers of endothelial dysfunction in acute states. Our aim was to assess the frequency of coagulation abnormalities in the early phase of AP and evaluate the relationships between serum angiopoietin-2 and sFlt-1 and severity of coagulopathy. Sixty-nine adult patients with AP were recruited: five with SAP, 15 with moderately severe AP (MSAP) and 49 with mild AP. Six patients were diagnosed with DIC according to International Society on Thrombosis and Haemostasis (ISTH) score. All patients had at least one abnormal result of routine tests of hemostasis (low platelet count, prolonged clotting times, decreased fibrinogen, and increased D-dimer). The severity of coagulopathy correlated with AP severity according to 2012 Atlanta criteria, bedside index of severity in AP and duration of hospital stay. D-dimers correlated independently with C-reactive protein and studied markers of endothelial dysfunction. Angiopoietin-2, D-dimer, and ISTH score were best predictors of SAP, while sFlt-1 was good predictor of MSAP plus SAP. In clinical practice, routine tests of hemostasis may assist prognosis of AP.
authors.affiliation: Department of Medical Diagnostics, Jagiellonian University Medical College, Medyczna 9, 30-688 Kraków, Poland. paulina.dumnicka@uj.edu.pl.
authors.forename: Paulina
authors.initials: P
authors.lastname: Dumnicka
authors.affiliation: Department of Diagnostics, Chair of Clinical Biochemistry, Jagiellonian University Medical College, Kopernika 15A, 31-501 Kraków, Poland. mbkusnie@cyf-kr.edu.pl.
authors.forename: Beata
authors.initials: B
authors.lastname: Kuśnierz-Cabala
authors.affiliation: Department of Anatomy, Jagiellonian University Medical College, Kopernika 12, 31-034 Kraków, Poland. msporek1983@gmail.com.|Surgery Department, The District Hospital, Szpitalna 22, 34-200 Sucha Beskidzka, Poland. msporek1983@gmail.com.
authors.forename: Mateusz
authors.initials: M
authors.lastname: Sporek
authors.affiliation: Department of Diagnostics, University Hospital, Kopernika 15B, 31-501 Kraków, Poland. mbmazur@cyf-kr.edu.pl.
authors.forename: Małgorzata
authors.initials: M
authors.lastname: Mazur-Laskowska
authors.affiliation: Department of Pathophysiology, Jagiellonian University Medical College, Czysta 18, 31-121 Kraków, Poland. mpgil@cyf-kr.edu.pl.
authors.forename: Krzysztof
authors.initials: K
authors.lastname: Gil
authors.affiliation: Chair and Department of Nephrology, Jagiellonian University Medical College, Kopernika 15, 31-501 Kraków, Poland. marek.kuzniewski@uj.edu.pl.
authors.forename: Marek
authors.initials: M
authors.lastname: Kuźniewski
authors.affiliation: Department of Physiology, Jagiellonian University Medical College, Grzegórzecka 16, 31-531 Kraków, Poland. piotr.ceranowicz@uj.edu.pl.
authors.forename: Piotr
authors.initials: P
authors.lastname: Ceranowicz
authors.affiliation: Department of Physiology, Jagiellonian University Medical College, Grzegórzecka 16, 31-531 Kraków, Poland. zygmunt.warzecha@uj.edu.pl.
authors.forename: Zygmunt
authors.initials: Z
authors.lastname: Warzecha
authors.affiliation: Department of Physiology, Jagiellonian University Medical College, Grzegórzecka 16, 31-531 Kraków, Poland. artur.dembinski@uj.edu.pl.
authors.forename: Artur
authors.initials: A
authors.lastname: Dembiński
authors.affiliation: Department of Medical Physiology, Jagiellonian University Medical College, Michałowskiego 12, 31-126 Kraków, Poland. joanna.bonior@uj.edu.pl.
authors.forename: Joanna
authors.initials: J
authors.lastname: Bonior
authors.affiliation: Department of Medical Diagnostics, Jagiellonian University Medical College, Medyczna 9, 30-688 Kraków, Poland. ryszard.drozdz@uj.edu.pl.
authors.forename: Ryszard
authors.initials: R
authors.lastname: Drożdż
mesh_terms: D000208:Acute Disease; D000368:Aged; D000369:Aged, 80 and over; D042702:Angiopoietin-2 / Q000097:blood*; D015415:Biomarkers / Q000097:blood; D001778:Blood Coagulation Disorders / Q000097:blood* / Q000150:complications / Q000175:diagnosis; D002097:C-Reactive Protein / Q000378:metabolism; D005260:Female; D005338:Fibrin Fibrinogen Degradation Products / Q000378:metabolism; D006801:Humans; D016015:Logistic Models; D008297:Male; D008875:Middle Aged; D010195:Pancreatitis / Q000150:complications*; D011379:Prognosis; D011446:Prospective Studies; D012720:Severity of Illness Index; D012995:Solubility; D040281:Vascular Endothelial Growth Factor Receptor-1 / Q000097:blood*
chemical_list: D042702:Angiopoietin-2; D015415:Biomarkers; D005338:Fibrin Fibrinogen Degradation Products; C036309:fibrin fragment D; D002097:C-Reactive Protein; D040281:Vascular Endothelial Growth Factor Receptor-1
keywords: D-dimer; acute pancreatitis; angiopoietin-2; disseminated intravascular coagulation; soluble fms-like tyrosine kinase 1