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C-terminal proendothelin-1 (CT-proET-1) is associated with organ failure and
predicts mortality in critically ill patients
#MMPMID28331622
Buendgens L
; Yagmur E
; Bruensing J
; Herbers U
; Baeck C
; Trautwein C
; Koch A
; Tacke F
J Intensive Care
2017[]; 5
(?): 25
PMID28331622
show ga
BACKGROUND: Endothelin 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. METHODS: Two 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. RESULTS: CT-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). CONCLUSIONS: CT-proET-1 serum
concentrations at admission are increased in critically ill patients and
associated with sepsis, disease severity, organ failure, and mortality.