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

Nie,Wanpin; Wang,Yan; Yao,Kai; Wang,Zheng; Wu,Hao

doi:10.3892/etm.2016.3466

September-2016 Volume 12 Issue 3

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September-2016 Volume 12 Issue 3

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Article Open Access

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

Authors:
- Wanpin Nie
- Yan Wang
- Kai Yao
- Zheng Wang
- Hao Wu
View Affiliations / Copyright

Affiliations: Department of Vascular Surgery, The Third Xiangya Hospital, Central South University, Changsha, Hunan 410013, P.R. China

Copyright: © Nie et al. This is an open access article distributed under the terms of Creative Commons Attribution License.
Pages: 1412-1418
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Published online on: June 17, 2016

https://doi.org/10.3892/etm.2016.3466
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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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1	Burillo E, Lindholt JS, Molina-Sánchez P, Jorge I, Martinez-Pinna R, Blanco-Colio LM, Tarin C, Torres-Fonseca MM, Esteban M, Laustsen J, et al: ApoA-I/HDL-C levels are inversely associated with abdominal aortic aneurysm progression. Thromb Haemost. 113:1335–1346. 2015. View Article : Google Scholar : PubMed/NCBI
2	Bhak RH, Wininger M, Johnson GR, Lederle FA, Messina LM, Ballard DJ and Wilson SE: Factors associated with small abdominal aortic aneurysm expansion rate. JAMA Surg. 150:44–50. 2015. View Article : Google Scholar : PubMed/NCBI
3	Al-Omran M, Verma S, Lindsay TF, Weisel RD and Sternbach Y: Clinical decision making for endovascular repair of abdominal aortic aneurysm. Circulation. 110:e517–e523. 2004. View Article : Google Scholar : PubMed/NCBI
4	Raats JW, Flu HC, Ho GH, Veen EJ, Vos LD, Steyerberg EW and van der Laan L: Long-term outcome of ruptured abdominal aortic aneurysm: Impact of treatment and age. Clin Interv Aging. 9:1721–1732. 2014. View Article : Google Scholar : PubMed/NCBI
5	Krenzien F, Matia I, Wiltberger G, Hau HM, Schmelzle M, Jonas S, Kaisers UX and Fellmer PT: Early prediction of survival after open surgical repair of ruptured abdominal aortic aneurysms. BMC Surg. 14:922014. View Article : Google Scholar : PubMed/NCBI
6	Domenighetti AA, Wang Q, Egger M, Richards SM, Pedrazzini T and Delbridge LM: Angiotensin II-mediated phenotypic cardiomyocyte remodeling leads to age-dependent cardiac dysfunction and failure. Hypertension. 46:426–432. 2005. View Article : Google Scholar : PubMed/NCBI
7	Raizada MK and Ferreira AJ: ACE2: A new target for cardiovascular disease therapeutics. J Cardiovasc Pharmacol. 50:112–119. 2007. View Article : Google Scholar : PubMed/NCBI
8	Wang M, Zhang W, Zhou Y and Zhou X: Association between serum angiotensin-converting enzyme 2 levels and postoperative myocardial infarction following coronary artery bypass grafting. Exp Ther Med. 7:1721–1727. 2014.PubMed/NCBI
9	Li X, Zhou C and Hu W: Association between serum angiotensin-converting enzyme 2 level with postoperative morbidity and mortalityafter major pulmonary resection in non-small cell lung cancer patients. Heart Lung Circ. 23:661–666. 2014. View Article : Google Scholar : PubMed/NCBI
10	Sakalihasan N, Limet R and Defawe OD: Abdominal aortic aneurysm. Lancet. 365:1577–1589. 2005. View Article : Google Scholar : PubMed/NCBI
11	Yan Y: Logistic regression analysis. Medical statistics. Sun ZQ and Xu YY: (2nd). People's Medical Publishing House. (Beijing). 2922010.(In Chinese).
12	Dahlin LG, Olin C and Svedjeholm R: Perioperative Myocardial Infarction in Cardiac Surgery: Risk Factors and Consequences: A Case Control Study. Scand Cardiovasc J. 34:522–527. 2000. View Article : Google Scholar : PubMed/NCBI
13	Andesberg G, Beattie WS, Mosseri M, Jaffe AS and Alpert JS: Perioperative Myocardial Infarction. Circulation. 119:2936–2944. 2009. View Article : Google Scholar : PubMed/NCBI
14	Lim CC, Cuculi F, van Gaal WJ, Testa L, Arnold JR, Karamitsos T, Francis JM, Digby JE, Antoniades C, Kharbanda RK, et al: Early diagnosis of perioperative myocardial infarction after coronary bypass grafting: A study using biomarkers and cardiac magnetic resonance imaging. Ann Thorac Surg. 92:2046–2053. 2011. View Article : Google Scholar : PubMed/NCBI
15	Steyerberg EW, Kievit J, de Mol Van Otterloo JC, van Bockel JH, Eijkemans MJ and Habbema JD: Perioperative mortality of elective abdominal aortic aneurysm surgery. A clinical prediction rule based on literature and individual patient data. Arch Intern Med. 155:1998–2004. 1995. View Article : Google Scholar : PubMed/NCBI