Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
. 2020 Jul 20;133(14):1662-1668.
doi: 10.1097/CM9.0000000000000812.

Higher serum angiopoietin 2 levels are independently associated with coronary microvascular dysfunction in patients with angina in the absence of obstructive coronary artery disease

Shao-Min Chen  1 , Dan Li  1 , Xing Xing  2 , Zhao-Ping Li  1
Affiliations

Higher serum angiopoietin 2 levels are independently associated with coronary microvascular dysfunction in patients with angina in the absence of obstructive coronary artery disease

Shao-Min Chen et al. Chin Med J (Engl). .

Abstract

Background: Angiopoietin-2 (Ang-2) is a type of endothelial growth factor involved in angiogenesis and vascular remodeling. Circulating Ang-2 levels are elevated in patients with obstructive coronary artery disease (CAD). This study aimed to evaluate the association between serum Ang-2 levels and coronary microvascular dysfunction in patients without obstructive CAD.

Methods: A total of 125 patients with angina in the absence of obstructive CAD were included in this cross-sectional study. Coronary flow reserve (CFR) was measured in the distal left anterior descending coronary artery by trans-thoracic Doppler echocardiography. The patients were divided into the following two sub-groups according to CFR: the impaired CFR group with CFR values <2.5 and the preserved CFR group with CFR values ≥2.5. Serum Ang-2 levels were determined using enzyme-linked immunosorbent assay. Independent predictors for impaired CFR were identified by binary logistic regression analysis. The receiver-operating characteristic curve was determined to evaluate the ability of serum Ang-2 in predicting impaired CFR.

Results: We found that age, percentage of female sex, N-terminal pro-B-type natriuretic peptide levels, Ang-2 levels (763.3 ± 264.9 vs. 579.7 ± 169.3 pg/mL, P < 0.001), and the left atrial volume index were significantly higher in patients with impaired CFR than in patients with preserved CFR. Serum Ang-2 levels were negatively correlated with CFR (r = -0.386, P < 0.001). Binary logistic regression analysis showed that Ang-2 (odds ratio: 1.004, 95% confidence interval [CI]: 1.001-1.006, P = 0.003) and age (odds ratio: 1.088, 95% CI: 1.023-1.156, P = 0.007) were independently associated with impaired CFR. Furthermore, Ang-2 was a significant predictor of impaired CFR on the receiver-operating characteristic curve (P < 0.001). The area under the curve was 0.712 (95% CI: 0.612-0.813).

Conclusions: High serum Ang-2 levels are independently associated with impaired CFR in patients with angina in the absence of obstructive CAD.

PubMed Disclaimer

Conflict of interest statement

None.

Figures

Figure 1
Figure 1
Relationship between serum angiopoietin-2 levels and coronary flow reserve.
Figure 2
Figure 2
Receiver-operating characteristics curve analysis of serum angiopoietin-2 for impaired coronary flow reserve. Area under the curve = 0.712, P < 0.001, and impaired CFR was defined as CFR values <2.5. CFR: Coronary flow reserve.
Figure 3
Figure 3
Association of serum angiopoietin-2 with gender, hypertension, age, and E/e′. (A) Serum angiopoietin-2 levels were significantly higher in females than in males. (B) Serum angiopoietin-2 levels were significantly higher in hypertensive patients than in non-hypertensive patients (B). (C, D) Serum Ang-2 levels were positively correlated with age and E/e′, respectively. Ang-2: Angiopoietin 2; E/e′: Early diastolic mitral inflow velocity/early diastolic mitral annular velocity.
See this image and copyright information in PMC

References

    1. Radico F, Cicchitti V, Zimarino M, De Caterina R. Angina pectoris and myocardial ischemia in the absence of obstructive coronary artery disease: practical considerations for diagnostic tests. JACC Cardiovasc Interv 2014; 7:453–463. doi: 10.1016/j.jcin.2014.01.157. - PubMed
    1. Sara JD, Widmer RJ, Matsuzawa Y, Lennon RJ, Lerman LO, Lerman A. Prevalence of coronary microvascular dysfunction among patients with chest pain and non obstructive coronary artery disease. JACC Cardiovasc Interv 2015; 8:1445–1453. doi: 10.1016/j.jcin.2015.06.017. - PubMed
    1. Lee JH, Han D, Hartaigh BÓ, Gransar H, Lu Y, Rizvi A, et al. Influence of symptom typicality for predicting MACE in patients without obstructive coronary artery disease: from the CONFIRM Registry (Coronary Computed Tomography Angiography Evaluation for Clinical Outcomes: An International Multicenter Registry). Clin Cardiol 2018; 41:586–593. doi: 10.1002/clc.22940. - PMC - PubMed
    1. Rizzi A, Benagiano V, Ribatti D. Angiogenesis versus arteriogenesis. Rom J Morphol Embryol 2017; 58:15–19. - PubMed
    1. Suri C, Jones PF, Patan S, Bartunkova S, Maisonpierre PC, Davis S, et al. Requisite role of angiopoietin-1, a ligand for the TIE2 receptor, during embryonic angiogenesis. Cell 1996; 87:1171–1180. - PubMed