Angiopoietin-2 as a biomarker of non-ST-segment elevation myocardial infarction in patients with or without type 2 diabetes

Tomasz Skowerski; Katarzyna Nabrdalik; Hanna Kwiendacz; Maciej Pajak; Katarzyna Mizia-Stec; Zbigniew Gasior; Janusz Gumprecht

doi:10.5114/aoms.2019.89201

Angiopoietin-2 as a biomarker of non-ST-segment elevation myocardial infarction in patients with or without type 2 diabetes

Arch Med Sci. 2019 Nov 7;18(3):624-631. doi: 10.5114/aoms.2019.89201. eCollection 2022.

Authors

Tomasz Skowerski^{1

2}, Katarzyna Nabrdalik¹, Hanna Kwiendacz¹, Maciej Pajak³, Katarzyna Mizia-Stec⁴, Zbigniew Gasior², Janusz Gumprecht¹

Affiliations

¹ Department of Internal Medicine, Diabetology and Nephrology, Medical University of Silesia, Zabrze, Poland.
² Department of Cardiology, School of Health Sciences, Medical University of Silesia, Katowice, Poland.
³ Roslin Institute, Midlothian, Edinburgh, United Kingdom of Great Britain & Northern Ireland.
⁴ First Department of Cardiology, School of Medicine in Katowice, Medical University of Silesia, Katowice, Poland.

Abstract

Introduction: Angiopoietin-2 (Ang-2) is a novel marker of coronary artery disease (CAD) and diabetes (DM). The aim was to evaluate Ang-2 as a potential new biomarker of non-ST elevation myocardial infarction (NSTEMI) in patients with or without type 2 DM (T2DM).

Material and methods: This was a multi-center, prospective study that included 138 (males: 91/66%) consecutive patients hospitalized due to NSTEMI, T2DM, or different cardiac disorders. The subjects were divided into four study groups: group A: 28 patients with NSTEMI and T2DM; group B: 47 patients with NSTEMI without T2DM; group C: 31 patients with T2DM, without a history of CAD; group D: 32 patients as a control group. Patients with NSTEMI underwent urgent coronarography. Clinical characteristics including biomarkers (hs-CRP, hsTnT, NT-proBNP, VEGF, HbA_1c), SYNTAX SCORE, type of intervention (PCI vs. CABG), and number of implanted stents were taken into account in the analysis.

Results: Serum Ang-2 concentrations were significantly higher in patients with NSTEMI (group A: 1769 pg/ml; group B: 1757 pg/ml) and patients with T2DM (group C: 1993 pg/ml) as compared to the patients without CAD and without T2DM (group D: 866.8 pg/ml; p < 0.05). The prognostic accuracy of Ang-2 in NSTEMI diagnosis was determined with the area under the ROC curve (area under curve (AUC) = 0.63).

Conclusions: Angiopoietin-2 serum concentration is elevated in the presence of NSTEMI in patients with and without T2DM and does not correspond to the degree of myocardial injury and hemodynamic status. Ang-2 remains elevated also in patients with T2DM without a history of CAD.

Keywords: angiopoietin; angiopoietin-2; biomarker; diabetes; non-ST elevation myocardial infarction.