1. Angiotensin I and angiotensin II concentrations and their ratio in catecholamine-resistant vasodilatory shock
- Author
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Bellomo, Rinaldo, Wunderink, Richard G, Szerlip, Harold, English, Shane W, Busse, Laurence W, Deane, Adam M, Khanna, Ashish K, McCurdy, Michael T, Ostermann, Marlies, Young, Paul J, Handisides, Damian R, Chawla, Lakhmir S, Tidmarsh, George F, and Albertson, Timothy E
- Subjects
Biomedical and Clinical Sciences ,Clinical Sciences ,Clinical Research ,Cardiovascular ,6.1 Pharmaceuticals ,Evaluation of treatments and therapeutic interventions ,Angiotensin I ,Angiotensin II ,Catecholamines ,Female ,Humans ,Male ,Shock ,ACE ,ACE dysfunction ,Sepsis ,Vasodilatory shock ,Medical and Health Sciences ,Emergency & Critical Care Medicine ,Biomedical and clinical sciences ,Health sciences - Abstract
BackgroundIn patients with vasodilatory shock, plasma concentrations of angiotensin I (ANG I) and II (ANG II) and their ratio may reflect differences in the response to severe vasodilation, provide novel insights into its biology, and predict clinical outcomes. The objective of these protocol prespecified and subsequent post hoc analyses was to assess the epidemiology and outcome associations of plasma ANG I and ANG II levels and their ratio in patients with catecholamine-resistant vasodilatory shock (CRVS) enrolled in the Angiotensin II for the Treatment of High-Output Shock (ATHOS-3) study.MethodsWe measured ANG I and ANG II levels at baseline, calculated their ratio, and compared these results to values from healthy volunteers (controls). We dichotomized patients according to the median ANG I/II ratio (1.63) and compared demographics, clinical characteristics, and clinical outcomes. We constructed a Cox proportional hazards model to test the independent association of ANG I, ANG II, and their ratio with clinical outcomes.ResultsMedian baseline ANG I level (253 pg/mL [interquartile range (IQR) 72.30-676.00 pg/mL] vs 42 pg/mL [IQR 30.46-87.34 pg/mL] in controls; P
- Published
- 2020