Circulating angiopoietin-2 and the risk of mortality in patients with acute respiratory distress syndrome: a systematic review and meta-analysis of 10 prospective cohort studies.
BACKGROUND
Angiopoietin-2 (Ang-2), as one of the ligands of endothelial receptor Tie2, is known to be significant for vessel maturation and stabilization after birth. Previous studies showed the relationship between Ang-2 level and the risk of mortality in patients with acute respiratory distress syndrome (ARDS). However, the link between circulating Ang-2 and the risk of mortality in patients with ARDS varied in different investigations.


RESULTS
We performed a systematic review and meta-analysis of all available cohort studies regarding the association between baseline circulating Ang-2 and mortality in patients with ARDS. Among the 10 eligible studies, pooled odds ratio (OR) showed that high Ang-2 level contributed to ARDS mortality [OR = 1.56, 95% confidence interval (CI): 1.30-1.89, I2 = 76.2%]. Stratified analysis revealed that higher circulating Ang-2 was related to a 30% higher risk in the high-quality scores group (OR = 1.68, 95% CI: 1.33-2.68, I2 = 62.4%). The I2 of the bad compliance group decreased from 76.2% to 8.5%, which suggested that compliance is a significant source of heterogeneity. This association may be blunted by potential bias, although the results was not meaningfully changed by omitting only one study at a time. Further subgroup analysis and meta-regression support that compliance of patients also affects the results significantly, compared with the publication year, follow-up duration, the samples, or population characteristics.


CONCLUSION
Participants with higher baseline Ang-2 were at a higher risk for future risk of mortality in patients with ARDS. Higher circulating Ang-2 levels could independently predict the risk of mortality in patients with ARDS. However, further large scale prospective cohorts or even interventional studies are warranted to evaluate the diagnostic power of Ang-2 and its causative role on ARDS outcome. The reviews of this paper are available via the supplemental material section.
['Li|Fengyuan|F|', 'Yin|Rulan|R|', 'Guo|Qiang|Q|0000-0002-8853-9822']
D000293:Adolescent D000328:Adult D042702:Angiopoietin-2 D015415:Biomarkers D002648:Child D002675:Child, Preschool D005260:Female D006801:Humans D007223:Infant D008297:Male D008875:Middle Aged D011237:Predictive Value of Tests D011379:Prognosis D012128:Respiratory Distress Syndrome D018570:Risk Assessment D012307:Risk Factors D015854:Up-Regulation D055815:Young Adult
angiopoietin-2 mortality acute respiratory distress syndrome meta-analysis