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Serum angiotensin-converting enzyme 2 is an independent risk factor for in-hospital mortality following open surgical repair of ruptured abdominal aortic aneurysm

View Article: PubMed Central - PubMed

ABSTRACT

Open surgical repair (OSR) is a conventional surgical method used in the repair a ruptured abdominal aortic aneurysm (AAA); however, OSR results in high perioperative mortality rates. The level of serum angiotensin-converting enzyme 2 (ACE2) has been reported to be an independent risk factor for postoperative in-hospital mortality following major cardiopulmonary surgery. In the present study, the association of serum ACE2 levels with postoperative in-hospital mortality was investigated in patients undergoing OSR for ruptured AAA. The study enrolled 84 consecutive patients underwent OSR for ruptured AAA and were subsequently treated in the intensive care unit. Patients who succumbed postoperatively during hospitalization were defined as non-survivors. Serum ACE2 levels were measured in all patients prior to and following the surgery using ELISA kits. The results indicated that non-survivors showed significantly lower mean preoperative and postoperative serum ACE2 levels when compared with those in survivors. Multivariate logistic regression analysis also showed that, subsequent to adjusting for potential confounders, the serum ACE2 level on preoperative day 1 showed a significant negative association with the postoperative in-hospital mortality. This was confirmed by multivariate hazard ratio analysis, which showed that, subsequent to adjusting for the various potential confounders, the risk of postoperative in-hospital mortality remained significantly higher in the two lowest serum ACE2 level quartiles compared with that in the highest quartile on preoperative day 1. In conclusion, the present study provided the first evidence supporting that the serum ACE2 level is an independent risk factor for the in-hospital mortality following OSR for ruptured AAA. Furthermore, low serum ACE2 levels on preoperative day 1 were found to be associated with increased postoperative in-hospital mortality. Therefore, the serum ACE2 level on preoperative day 1 may be a potential biomarker or prognostic factor for in-hospital mortality following OSR for ruptured AAA.

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Related in: MedlinePlus

Preoperative and postoperative serum ACE2 levels in survivors and non-survivors. (A) Serum ACE2 levels were measured using a human ACE2 ELISA kit in patients undergoing OSR for ruptured AAA on preoperative days 3, 2 and 1, at 1 h after surgery and at postoperative days 1, 2 and 3. The serum ACE2 levels were compared between patients succumbing postoperatively during hospitalization (non-survivors) and patients that survived postoperatively (survivors). (B) Mean preoperative and postoperative serum ACE2 levels were compared between non-survivors and survivors. *P<0.05 vs. non-survivors. ACE2, angiotensin-converting enzyme 2.
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f1-etm-0-0-3466: Preoperative and postoperative serum ACE2 levels in survivors and non-survivors. (A) Serum ACE2 levels were measured using a human ACE2 ELISA kit in patients undergoing OSR for ruptured AAA on preoperative days 3, 2 and 1, at 1 h after surgery and at postoperative days 1, 2 and 3. The serum ACE2 levels were compared between patients succumbing postoperatively during hospitalization (non-survivors) and patients that survived postoperatively (survivors). (B) Mean preoperative and postoperative serum ACE2 levels were compared between non-survivors and survivors. *P<0.05 vs. non-survivors. ACE2, angiotensin-converting enzyme 2.

Mentions: Serum ACE2 levels were measured in all patients on preoperative days 3, 2 and 1, at 1 h after surgery and on postoperative days 1, 2 and 3. A shown in Fig. 1A, the serum ACE2 levels of non-survivors were significantly lower compared with those in survivors, preoperatively and on postoperative days 2 and 3 (P<0.05). However, there was no significant difference in the mean serum ACE2 levels prior to and following surgery in non-survivors or in survivors (Fig. 1B). The findings suggested that the serum ACE2 level may be a predictive indicator for the in-hospital mortality following OSR for ruptured AAA, since the level was consistently increased in non-survivors.


Serum angiotensin-converting enzyme 2 is an independent risk factor for in-hospital mortality following open surgical repair of ruptured abdominal aortic aneurysm
Preoperative and postoperative serum ACE2 levels in survivors and non-survivors. (A) Serum ACE2 levels were measured using a human ACE2 ELISA kit in patients undergoing OSR for ruptured AAA on preoperative days 3, 2 and 1, at 1 h after surgery and at postoperative days 1, 2 and 3. The serum ACE2 levels were compared between patients succumbing postoperatively during hospitalization (non-survivors) and patients that survived postoperatively (survivors). (B) Mean preoperative and postoperative serum ACE2 levels were compared between non-survivors and survivors. *P<0.05 vs. non-survivors. ACE2, angiotensin-converting enzyme 2.
© Copyright Policy - open-access
Related In: Results  -  Collection

License
Show All Figures
getmorefigures.php?uid=PMC4998157&req=5

f1-etm-0-0-3466: Preoperative and postoperative serum ACE2 levels in survivors and non-survivors. (A) Serum ACE2 levels were measured using a human ACE2 ELISA kit in patients undergoing OSR for ruptured AAA on preoperative days 3, 2 and 1, at 1 h after surgery and at postoperative days 1, 2 and 3. The serum ACE2 levels were compared between patients succumbing postoperatively during hospitalization (non-survivors) and patients that survived postoperatively (survivors). (B) Mean preoperative and postoperative serum ACE2 levels were compared between non-survivors and survivors. *P<0.05 vs. non-survivors. ACE2, angiotensin-converting enzyme 2.
Mentions: Serum ACE2 levels were measured in all patients on preoperative days 3, 2 and 1, at 1 h after surgery and on postoperative days 1, 2 and 3. A shown in Fig. 1A, the serum ACE2 levels of non-survivors were significantly lower compared with those in survivors, preoperatively and on postoperative days 2 and 3 (P<0.05). However, there was no significant difference in the mean serum ACE2 levels prior to and following surgery in non-survivors or in survivors (Fig. 1B). The findings suggested that the serum ACE2 level may be a predictive indicator for the in-hospital mortality following OSR for ruptured AAA, since the level was consistently increased in non-survivors.

View Article: PubMed Central - PubMed

ABSTRACT

Open surgical repair (OSR) is a conventional surgical method used in the repair a ruptured abdominal aortic aneurysm (AAA); however, OSR results in high perioperative mortality rates. The level of serum angiotensin-converting enzyme 2 (ACE2) has been reported to be an independent risk factor for postoperative in-hospital mortality following major cardiopulmonary surgery. In the present study, the association of serum ACE2 levels with postoperative in-hospital mortality was investigated in patients undergoing OSR for ruptured AAA. The study enrolled 84 consecutive patients underwent OSR for ruptured AAA and were subsequently treated in the intensive care unit. Patients who succumbed postoperatively during hospitalization were defined as non-survivors. Serum ACE2 levels were measured in all patients prior to and following the surgery using ELISA kits. The results indicated that non-survivors showed significantly lower mean preoperative and postoperative serum ACE2 levels when compared with those in survivors. Multivariate logistic regression analysis also showed that, subsequent to adjusting for potential confounders, the serum ACE2 level on preoperative day 1 showed a significant negative association with the postoperative in-hospital mortality. This was confirmed by multivariate hazard ratio analysis, which showed that, subsequent to adjusting for the various potential confounders, the risk of postoperative in-hospital mortality remained significantly higher in the two lowest serum ACE2 level quartiles compared with that in the highest quartile on preoperative day 1. In conclusion, the present study provided the first evidence supporting that the serum ACE2 level is an independent risk factor for the in-hospital mortality following OSR for ruptured AAA. Furthermore, low serum ACE2 levels on preoperative day 1 were found to be associated with increased postoperative in-hospital mortality. Therefore, the serum ACE2 level on preoperative day 1 may be a potential biomarker or prognostic factor for in-hospital mortality following OSR for ruptured AAA.

No MeSH data available.


Related in: MedlinePlus