Plasma angiopoietin-1, angiopoietin-2, angiopoietin receptor Tie-2, and vascular endothelial growth factor levels in acute coronary syndromes
Plasma angiopoietin-1, angiopoietin-2, angiopoietin receptor Tie-2, and vascular endothelial growth factor levels in acute coronary syndromes
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DOI：
10.1161/01.cir.0000138112.90641.7f
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发表时间：
2004-10-19
期刊：
影响因子：
37.8
通讯作者：
Blann, AD
中科院分区：
文献类型：
--
作者：
Lee, KW;Lip, GYH;Blann, AD
血管生成素(Angiopoietin, Ang) - 1和-2及其受体Tie-2和血管内皮生长因子（vascular endothelial growth factor， VEGF）调节血管生成，可能在心肌侧枝发育中起重要作用。据报道，在心肌梗死（MI）中生长因子及其受体水平升高，但急性冠状动脉事件后的变化尚不清楚。方法和结果：126例急性冠状动脉综合征患者（82例心肌梗死，44例不稳定型心绞痛）入院时（基线）和48小时（急性期）血浆ang1、ang2、Tie-2和VEGF水平。比较了40名稳定型心绞痛患者和40名健康对照者的基线水平。38例MI患者在6周和18周（慢性期）重复测量。心肌梗死患者基线Ang-2和Tie-2水平最高（P < 0.001）。心肌梗死合并不稳定型心绞痛患者的VEGF水平高于稳定型心绞痛患者和健康对照组（P < 0.001）。在急性心肌梗死患者中，观察到所有指标从基线到18周的一系列变化（均P < 0.001）。Ang-1水平从基线到6周没有变化，但在18周时升高。Ang-2变化遵循双相模式，在基线和6周时较高，但在48小时和18周时较低。Tie-2水平从基线开始升高，并在慢性期保持升高。VEGF在6周时达到峰值，然后在18周时向基线下降。结论：急性冠状动脉综合征患者血浆ang2、Tie-2和VEGF水平升高，但未见ang1水平升高。心肌梗死急性期至慢性期血浆中Ang-1、Ang-2、Tie-2、VEGF水平的变化及其相互关系可能反映了缺血坏死心肌血管生成活性的体内进展阶段。
Background - Angiopoietin (Ang) - 1 and - 2, their receptor Tie-2, and vascular endothelial growth factor ( VEGF) regulate angiogenesis and may be important in myocardial collateral development. Elevated levels of growth factors and their receptors are reported in myocardial infarction (MI), but changes after an acute coronary event are unknown.Methods and Results - Plasma Ang-1, Ang-2, Tie-2, and VEGF levels were measured on admission ( baseline) and at 48 hours ( acute stage) in 126 patients with acute coronary syndrome ( 82 MI, 44 unstable angina pectoris). Baseline levels were compared with those of 40 patients with stable angina and 40 healthy controls. Measurements were repeated in 38 MI patients at 6 and 18 weeks ( chronic stage). Baseline Ang-2 and Tie-2 levels were highest in MI patients ( P < 0.001). Patients with MI and unstable angina pectoris had higher VEGF levels compared with stable angina patients and healthy control subjects ( P < 0.001). In patients with acute MI, serial changes in all indexes from baseline to 18 weeks were observed ( all P < 0.001). Ang-1 levels were unchanged from baseline to 6 weeks but were elevated at 18 weeks. Ang-2 changes followed a biphasic pattern, being higher at baseline and 6 weeks but lower at 48 hours and 18 weeks. Tie-2 levels increased from baseline and remained elevated in the chronic phase. VEGF peaked at 6 weeks and then decreased toward baseline at 18 weeks.Conclusions - Plasma Ang-2, Tie-2, and VEGF levels but not Ang-1 levels were increased in patients with acute coronary syndrome. Serial changes in the plasma levels and interrelationships among Ang-1, Ang-2, Tie-2, and VEGF levels from the acute to the chronic stages in MI may reflect the progressive stages of angiogenesis activity in the ischemic-necrotic myocardium in vivo.