American journal of respiratory and critical care medicine
-
Am. J. Respir. Crit. Care Med. · Nov 2020
Editorial CommentA Plot TWIST in Pulmonary Arterial Hypertension.
-
Am. J. Respir. Crit. Care Med. · Nov 2020
Clinical TrialRenin and Survival in Patients Given Angiotensin II for Catecholamine-Resistant Vasodilatory Shock.
Rationale: Exogenous angiotensin II increases mean arterial pressure in patients with catecholamine-resistant vasodilatory shock (CRVS). We hypothesized that renin concentrations may identify patients most likely to benefit from such therapy. Objectives: To test the kinetic changes in renin concentrations and their prognostic value in patients with CRVS. ⋯ In patients with renin concentrations above the study population median, angiotensin II significantly reduced 28-day mortality to 28 of 55 (50.9%) patients compared with 51 of 73 patients (69.9%) treated with placebo (unstratified hazard ratio, 0.56; 95% confidence interval, 0.35 to 0.88; P = 0.012) (P = 0.048 for the interaction). Conclusions: The serum renin concentration is markedly elevated in CRVS and may identify patients for whom treatment with angiotensin II has a beneficial effect on clinical outcomes. Clinical trial registered with www.clinicaltrials.gov (NCT02338843).