Fernandez-Alonso Sebastian, Martinez-Aguilar Esther, Ravassa Susana, Orbe Josune, Paramo Jose A, Fernandez-Alonso Leopoldo, Roncal Carmen
Departamento de Angiología y Cirugía Vascular, Hospital Universitario de Navarra, 31008 Pamplona, Spain.
Instituto de Investigación Sanitaria de Navarra-IdiSNA, 31008 Pamplona, Spain.
Life (Basel). 2022 May 31;12(6):823. doi: 10.3390/life12060823.
Predicting the progression of small aneurysms is a main challenge in abdominal aortic aneurysm (AAA) management. The combination of circulating biomarkers and image techniques might provide an alternative for risk stratification. We evaluated the association of plasma TAT complexes (TAT) and D-dimer with AAA severity in 3 groups of patients: group 1, without AAA (n = 52), group 2, AAA 40−50 mm (n = 51) and group 3, AAA > 50 mm (n = 50). TAT (p < 0.001) and D-dimer (p < 0.001) were increased in patients with AAA (groups 2 and 3) vs. group 1. To assess the association between baseline TAT and D-dimer concentrations, and AAA growth, aortic diameter and volume (volumetry) were measured by computed tomography angiography (CTA) in group 2 at recruitment (baseline) and 1-year after inclusion. Baseline D-dimer and TAT levels were associated with AAA diameter and volume variations at 1-year independently of confounding factors (p ≤ 0.044). Additionally, surgery incidence, recorded during a 4-year follow-up in group 2, was associated with larger aneurysms, assessed by aortic diameter and volumetry (p ≤ 0.036), and with elevated TAT levels (sub-hazard ratio 1.3, p ≤ 0.029), while no association was found for D-dimer. The combination of hemostatic parameters and image techniques might provide valuable tools to evaluate AAA growth and worse evolution.
预测小动脉瘤的进展是腹主动脉瘤(AAA)治疗中的一项主要挑战。循环生物标志物与影像技术相结合可能为风险分层提供一种替代方法。我们评估了3组患者血浆凝血酶 - 抗凝血酶复合物(TAT)和D - 二聚体与AAA严重程度的关联:第1组,无AAA(n = 52);第2组,AAA直径40 - 50 mm(n = 51);第3组,AAA直径> 50 mm(n = 50)。与第1组相比,AAA患者(第2组和第3组)的TAT(p < 0.001)和D - 二聚体(p < 0.001)升高。为了评估基线TAT和D - 二聚体浓度与AAA生长之间的关联,在第2组患者入组时(基线)和纳入后1年通过计算机断层血管造影(CTA)测量主动脉直径和体积(容积测量)。基线D - 二聚体和TAT水平与1年后AAA直径和体积变化独立于混杂因素相关(p≤0.044)。此外,在第2组4年随访期间记录的手术发生率与通过主动脉直径和容积测量评估的较大动脉瘤相关(p≤0.036),并且与TAT水平升高相关(亚风险比1.3,p≤0.029),而未发现与D - 二聚体有关联。止血参数与影像技术相结合可能为评估AAA生长和不良进展提供有价值的工具。