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Olle Melander

Principal investigator

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Endostatin predicts mortality in patients with acute dyspnea – A cohort study of patients seeking care in emergency departments


  • A. C. Carlsson
  • T. Wessman
  • A. Larsson
  • G. Leijonberg
  • R. Tofik
  • J. Ärnlöv
  • O. Melander
  • T. Ruge

Summary, in English

Background: Increased levels of circulating endostatin predicts cardiovascular morbidity and impaired kidney function in the general population. The utility of endostatin as a risk marker for mortality in the emergency department (ED) has not been reported. Aim: Our main aim was to study the association between plasma endostatin and 90-day mortality in an unselected cohort of patients admitted to the ED for acute dyspnea. Design Circulating endostatin was analyzed in plasma from 1710 adults and related to 90-day mortality in Cox proportional hazard models adjusted for age, sex, body mass index, oxygen saturation, respiratory rate, body temperature, C-reactive protein, lactate, creatinine and medical priority according to the Medical Emergency Triage and Treatment System–Adult score (METTS-A). The predictive value of endostatin for mortality was evaluated with receiver operating characteristic (ROC) analysis and compared with the clinical triage scoring system and age. Results: Each one standard deviation increment of endostatin was associated with a HR of 2.12 (95% CI 1.31–3.44 p < 0.01) for 90-day mortality after full adjustment. Levels of endostatin were significantly increased in the group of patients with highest METTS-A (p < 0.001). When tested for the outcome 90-day mortality, the area under the ROC curve (AUC) was 0.616 for METTS-A, 0.701 for endostatin, 0.708 for METTS -A and age and 0.738 for METTS-A, age and levels of endostatin. Conclusions: In an unselected cohort of patients admitted to the ED with acute dyspnea, endostatin had a string association to 90-day mortality and improved prediction of 90-day mortality in the ED beyond the clinical triage scoring system and age with 3%.


  • Cardiovascular Research - Hypertension
  • EpiHealth: Epidemiology for Health
  • EXODIAB: Excellence in Diabetes Research in Sweden

Publishing year







Clinical Biochemistry



Document type

Journal article




  • Cardiac and Cardiovascular Systems
  • Cell and Molecular Biology


  • Acute dyspnea
  • Cardiovascular
  • Emergency department
  • Endostatin
  • Epidemiology
  • Mortality



Research group

  • Cardiovascular Research - Hypertension


  • ISSN: 0009-9120