C-terminal proendothelin-1 CT-proET-1 is associated with organ failure and predicts mortality in critically ill patientsReport as inadecuate




C-terminal proendothelin-1 CT-proET-1 is associated with organ failure and predicts mortality in critically ill patients - Download this document for free, or read online. Document in PDF available to download.

Journal of Intensive Care

, 5:25

First Online: 20 March 2017Received: 20 August 2016Accepted: 02 March 2017DOI: 10.1186-s40560-017-0219-y

Cite this article as: Buendgens, L., Yagmur, E., Bruensing, J. et al. j intensive care 2017 5: 25. doi:10.1186-s40560-017-0219-y

Abstract

BackgroundEndothelin 1 ET-1 is a strong vasoconstrictor, which is involved in inflammation and reduced tissue perfusion. C-terminal proendothelin-1 CT-proET-1 is the stable circulating precursor protein of ET-1. We hypothesized that CT-proET-1, reflecting ET-1 activation, is involved in the pathogenesis of critical illness and associated with its prognosis.

MethodsTwo hundred seventeen critically ill patients 144 with sepsis, 73 without sepsis were included prospectively upon admission to the medical intensive care unit ICU, in comparison to 65 healthy controls. CT-proET-1 serum concentrations were correlated with clinical data and extensive laboratory parameters. Overall survival was followed for up to 3 years.

ResultsCT-proET-1 serum levels at admission were significantly increased in critically ill patients compared to controls. CT-proET-1 serum levels showed significant correlations to systemic inflammation as well as multiple markers of organ dysfunction kidney, liver, heart. Patients with sepsis displayed higher circulating CT-proET-1 than ICU patients with non-septic diseases. CT-proET-1 levels >74 pmol-L at ICU admission independently predicted ICU death adjusted hazard ratio HR 2.66, 95% confidence interval CI 1.30–5.47 and overall mortality during follow-up adjusted HR 2.19, 95%-CI 1.21–3.98.

ConclusionsCT-proET-1 serum concentrations at admission are increased in critically ill patients and associated with sepsis, disease severity, organ failure, and mortality.

KeywordsC-terminal proendothelin-1 CT-proET-1 ICU Prognosis Sepsis Biomarker Critical illness Endothelin ET-1 Abbreviations95%-CI95% confidence interval

APACHEAcute Physiology and Chronic Health Evaluation

ARDSAcute respiratory distress syndrome

AUCArea under the curve

CRPC-reactive protein

CT-proET-1C-terminal proendothelin-1

ET-1Endothelin-1

HRHazard ratio

ICUIntensive care unit

NTproBNPN-terminal B-type natriuretic peptide

ROCReceiver operating characteristics

SAPS 2Simplified acute physiology score

SOFASequential Organ Failure Assessment

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Author: Lukas Buendgens - Eray Yagmur - Jan Bruensing - Ulf Herbers - Christer Baeck - Christian Trautwein - Alexander Koch - Frank

Source: https://link.springer.com/



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