Zarrouk Moncef, Keshavarz Kave, Lindblad Bengt, Gottsäter Anders
Department of Vascular Diseases, Skåne University Hospital, S-205 02, Malmö, Sweden,
J Thromb Thrombolysis. 2013 Nov;36(4):495-500. doi: 10.1007/s11239-013-0871-6.
To evaluate the use of activated protein C-protein C inhibitor (APC-PCI) complex levels for detection of abdominal aortic aneurysm (AAA) in patients with peripheral atherosclerotic disease (PAD). APC-PCI levels and aortic diameter evaluated in 511 PAD patients without previously known AAA followed-up concerning survival for 4.8(0.5) years. AAA was found in 13% of patients. Aortic diameter correlated (r = 0.138; p = 0.002) with APC-PCI levels which were higher (0.40[0.45] vs. 0.30[0.49] μg/l; p = 0.004) in patients with AAA. This difference persisted in multivariate analysis (p = 0.029). A threshold value of APC-PCI ≥0.15 μg/L showed a specificity of 11%, a sensitivity of 97% and a negative predictive value of 96% for an AAA diagnosis. APC-PCI levels were higher in patients with AAA, and showed high sensitivity but low specificity for the diagnosis and can therefore not be considered as a screening tool in PAD patients. An AAA prevalence of 13% in patients with PAD indicates a need for AAA screening within this population.
评估活化蛋白C-蛋白C抑制剂（APC-PCI）复合物水平用于检测外周动脉粥样硬化疾病（PAD）患者腹主动脉瘤（AAA）的价值。对511例既往无AAA的PAD患者进行APC-PCI水平和主动脉直径评估，并随访4.8（0.5）年观察生存情况。13%的患者发现有AAA。主动脉直径与APC-PCI水平相关（r = 0.138；p = 0.002），AAA患者的APC-PCI水平更高（0.40[0.45] vs. 0.30[0.49]μg/l；p = 0.004）。在多因素分析中这种差异仍然存在（p = 0.029）。APC-PCI≥0.15μg/L的阈值对AAA诊断的特异性为11%，敏感性为97%，阴性预测值为96%。AAA患者的APC-PCI水平更高，对诊断表现出高敏感性但低特异性，因此不能被视为PAD患者的筛查工具。PAD患者中AAA患病率为13%表明该人群需要进行AAA筛查。
