Nathalie De Vos , Marie Bruyneel , Alain Roman , Mathieu Antoine , Anne-Violette Bruyneel , Stephane Alard , Stéphanie André , Hafid Dahma , Audrey Chirumberro , Frédéric Cotton
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Contingency tables revealed predictive values. Odds ratio was calculated through logistic regression.</p></div><div><h3>Results</h3><p>Angiotensin 1–7 beneath 138 pg/mL defined Angiotensin imbalance phenotype. Hyper-inflammatory phenotype showed a composite index test above 34, based on high Angiotensin 1–7, C-Reactive Protein, Ferritin and Transforming Growth Factor-β. Analytical study showed conformity to predefined goals. Clinical performance gave a positive predictive value of 95 % (95 % confidence interval, 82 %–99 %), and a negative predictive value of 100 % (95 % confidence interval, 65 %–100 %). Those severe ARDS phenotypes represented 34 (Odds 95 % confidence interval, 3–355) times higher risk for pulmonary fibrosis development (<em>p < 0·001</em>).</p></div><div><h3>Conclusions</h3><p>Angiotensin 1–7 composite index is an early and objective predictor of ARDS evolving to pulmonary fibrosis. It may guide therapeutic decisions in targeted phenotypes.</p></div>","PeriodicalId":10205,"journal":{"name":"Clinica Chimica Acta","volume":null,"pages":null},"PeriodicalIF":3.2000,"publicationDate":"2024-08-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S000989812402179X/pdfft?md5=72bbcf0bab422ea7ac9ec449c174363a&pid=1-s2.0-S000989812402179X-main.pdf","citationCount":"0","resultStr":"{\"title\":\"Accuracy study of Angiotensin 1–7 composite index test to predict pulmonary fibrosis and guide treatment\",\"authors\":\"Nathalie De Vos , Marie Bruyneel , Alain Roman , Mathieu Antoine , Anne-Violette Bruyneel , Stephane Alard , Stéphanie André , Hafid Dahma , Audrey Chirumberro , Frédéric Cotton\",\"doi\":\"10.1016/j.cca.2024.119926\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<div><h3>Background</h3><p>Pulmonary fibrosis can develop after acute respiratory distress syndrome (ARDS). The hypothesis is we are able to measure phenotypes that lie at the origin of ARDS severity and fibrosis development. The aim is an accuracy study of prognostic circulating biomarkers.</p></div><div><h3>Methods</h3><p>A longitudinal study followed COVID-related ARDS patients with medical imaging, pulmonary function tests and biomarker analysis, generating 444 laboratory data. Comparison to controls used non-parametrical statistics; <em>p < 0·05</em> was considered significant. Cut-offs were obtained through receiver operating curve. Contingency tables revealed predictive values. Odds ratio was calculated through logistic regression.</p></div><div><h3>Results</h3><p>Angiotensin 1–7 beneath 138 pg/mL defined Angiotensin imbalance phenotype. Hyper-inflammatory phenotype showed a composite index test above 34, based on high Angiotensin 1–7, C-Reactive Protein, Ferritin and Transforming Growth Factor-β. Analytical study showed conformity to predefined goals. Clinical performance gave a positive predictive value of 95 % (95 % confidence interval, 82 %–99 %), and a negative predictive value of 100 % (95 % confidence interval, 65 %–100 %). Those severe ARDS phenotypes represented 34 (Odds 95 % confidence interval, 3–355) times higher risk for pulmonary fibrosis development (<em>p < 0·001</em>).</p></div><div><h3>Conclusions</h3><p>Angiotensin 1–7 composite index is an early and objective predictor of ARDS evolving to pulmonary fibrosis. 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Accuracy study of Angiotensin 1–7 composite index test to predict pulmonary fibrosis and guide treatment
Background
Pulmonary fibrosis can develop after acute respiratory distress syndrome (ARDS). The hypothesis is we are able to measure phenotypes that lie at the origin of ARDS severity and fibrosis development. The aim is an accuracy study of prognostic circulating biomarkers.
Methods
A longitudinal study followed COVID-related ARDS patients with medical imaging, pulmonary function tests and biomarker analysis, generating 444 laboratory data. Comparison to controls used non-parametrical statistics; p < 0·05 was considered significant. Cut-offs were obtained through receiver operating curve. Contingency tables revealed predictive values. Odds ratio was calculated through logistic regression.
Results
Angiotensin 1–7 beneath 138 pg/mL defined Angiotensin imbalance phenotype. Hyper-inflammatory phenotype showed a composite index test above 34, based on high Angiotensin 1–7, C-Reactive Protein, Ferritin and Transforming Growth Factor-β. Analytical study showed conformity to predefined goals. Clinical performance gave a positive predictive value of 95 % (95 % confidence interval, 82 %–99 %), and a negative predictive value of 100 % (95 % confidence interval, 65 %–100 %). Those severe ARDS phenotypes represented 34 (Odds 95 % confidence interval, 3–355) times higher risk for pulmonary fibrosis development (p < 0·001).
Conclusions
Angiotensin 1–7 composite index is an early and objective predictor of ARDS evolving to pulmonary fibrosis. It may guide therapeutic decisions in targeted phenotypes.
期刊介绍：
The Official Journal of the International Federation of Clinical Chemistry and Laboratory Medicine (IFCC)
Clinica Chimica Acta is a high-quality journal which publishes original Research Communications in the field of clinical chemistry and laboratory medicine, defined as the diagnostic application of chemistry, biochemistry, immunochemistry, biochemical aspects of hematology, toxicology, and molecular biology to the study of human disease in body fluids and cells.
The objective of the journal is to publish novel information leading to a better understanding of biological mechanisms of human diseases, their prevention, diagnosis, and patient management. Reports of an applied clinical character are also welcome. Papers concerned with normal metabolic processes or with constituents of normal cells or body fluids, such as reports of experimental or clinical studies in animals, are only considered when they are clearly and directly relevant to human disease. Evaluation of commercial products have a low priority for publication, unless they are novel or represent a technological breakthrough. Studies dealing with effects of drugs and natural products and studies dealing with the redox status in various diseases are not within the journal''s scope. Development and evaluation of novel analytical methodologies where applicable to diagnostic clinical chemistry and laboratory medicine, including point-of-care testing, and topics on laboratory management and informatics will also be considered. Studies focused on emerging diagnostic technologies and (big) data analysis procedures including digitalization, mobile Health, and artificial Intelligence applied to Laboratory Medicine are also of interest.
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