Systemic angiopoietin-1/2 dysregulation following cardiopulmonary bypass in adults. (11th January 2017)

• Record Type: Journal Article
• Authors: Charbonney, Emmanuel; Wilcox, Elizabeth; Shan, Yuexin; d'Empaire, Pablo Perez; Duggal, Abhijit; Rubenfeld, Gordon D; Liles, Conrad; Santos, Claudia Dos
• Is Part Of: Future science OA. Volume 3:Number 1(2017)
• Publication Date: 2017-01-11
• Subjects: angiopoietin -- biomarker -- cardiac surgery -- cardiopulmonary bypass -- length of stay -- vascular leakage -- vascular permeability; Medicine -- Periodicals; Biotechnology -- Periodicals; 610
• DOI: 10.4155/fsoa-2016-0072
• Languages: English
• ISSNs: 2056-5623

Abstract

Aim: Vascular leakage following cardiopulmonary bypass contributes to morbidity. Angiopoietin-1 and -2 are biomarkers of endothelial dysfunction. Our aim was to characterize Ang-1 and -2 association with clinical characteristics and outcomes.Methods: Observational cohort study measuring Ang-1/-2 with a panel of cytokines in adults undergoing cardiopulmonary bypass.Results: Ang-2 levels increased immediately postop whereas Ang-1 levels decreased over time. No significant correlation was found with other inflammatory mediators. High correlation was found between the hospital length of stay and Ang-2 increase at 24 h (rho = 0.590; p < 0.0001). The predictors of Ang-2 increase were female gender, cross clamp time, transfusion of blood and absence of angiotensin-converting enzyme inhibitor as a pre-op medication.Conclusion: Angiopoietins can detect vascular leakage early and could impact patient's management to decrease length of stay after cardiac surgery. Lay abstract: Following cardiac surgery, patients develop swelling due to fluid leaking from their vessels into their tissues. We know that more swelling contributes to a longer stay in the hospital. The present study links a marker of vessel instability, namely angiopoietin (which we think could contribute to detect leakage), with patient's hospital length of stay. We also report patient's characteristics that are related to the release of angiopoietin. The measure of this marker after cardiac surgery could provide physicians with an alert signal and trigger treatments to minimize swelling that could impact on hospital stay.