Low apolipoprotein A-II levels causally contribute to increased mortality in septic shock
Main finding · Septic shock mortality with low apolipoprotein A-II levels (Japan cohort)Result — go to the resultAdjusted odds ratio 1.05 95% CI 1.02–1.09Authors' conclusion
In septic shock, apolipoprotein A-II levels and ApoA2 genetic variations are important factors associated with outcome.
Study context
- Population
- Japanese patients with septic shock at ICU admission; Caucasian replication cohort (VASST)Japan cohort
- Participants
- 687 patients
- Exposure
- Low vs higher apolipoprotein A-II levels; ApoA2 rs6413453 GG vs AG/AA carriers
- Outcome
- In-hospital mortality (association with lipoprotein and apolipoprotein levels at ICU admission)
Methodological detailsreplication cohort, genome-wide association study (GWAS)-based polygenic scores
- Replication cohort
- GWAS-based polygenic scores
Main finding
As reported in the abstract
Septic shock mortality with low apolipoprotein A-II levels (Japan cohort)
Adjusted odds ratio
1.05
95% CI 1.02–1.09
P < 0.001
Low apolipoprotein A-II
aOR 1.05 (95% CI 1.02–1.09); P < 0.001
Observational data: associations, not effects.
Further findings
| Outcome | aHR (95% CI) | P value | |
|---|---|---|---|
| 28-day mortality, rs6413453 GG vs AG/AA (Japan cohort) | 1.79 (1.06–3.04) | P = 0.029 | |
| 28-day mortality, GG vs AG/AA (Caucasian VASST replication cohort) · replication cohort, n = 474 | 1.65 (1.02–2.68) | P = 0.041 | |
| 0.20.5125Adjusted hazard ratio (log scale) |
| Outcome | OR (95% CI) | P value |
|---|---|---|
| Mortality per 1 mg/dL genetically decreased apolipoprotein A-II (Mendelian randomization, 9 SNPs)CI as printed | 1.05 (1.01–1.03) | P = 0.0022 |
Days free of cardiovascular, respiratory, renal and neurologic dysfunction, GG vs AG/AA
- Significantly fewer days free of organ dysfunction in GG carriers
Original publication
Low apolipoprotein A-II levels causally contribute to increased mortality in septic shock. J Intensive Care. Published 20 February 2025. doi:10.
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