Prediction of abdominal aortic aneurysm calcification by means of variation of high-sensitivity C-reactive protein

Abstract

ObjectiveAbdominal aortic aneurysms are a major cause of death in developed countries, and thrombus and calcification of the aneurysm have been linked to increased complications. This study was conducted in order to identify the biochemical marker associated to the presence of intraluminal thrombus or calcification progression of the aneurysm.DesignSeveral clinical laboratory parameters were measured in patients with abdominal aortic aneurysms, in particular those already demonstrated to be related to the pathology, such as lipoprotein (a), white blood cell count, fibrinogen and high-sensitivity C-reactive protein. Most of the patients were analysed for the presence of thrombus or aorta calcification using CT angiography.ResultsUnlike previous findings, we found no association between intraluminal thrombus formation and lipoprotein (a), but we evidenced that patients with lower grade of calcification tend to have higher plasma high-sensitivity C-reactive protein values compared with patients with a higher degree of calcification. Instead, no association was found with either white blood cell count or fibrinogen level.ConclusionsThis study suggests that high-sensitivity C-reactive protein is a useful biomarker to assess the evolution of calcification and could be used in triaging patients to identify those who should undergo a rapid imaging, thus allowing prompt initiation of treatment or rule-out suspicious patients from non-essential imaging repetition.

A Simple Blood Test, Such as Complete Blood Count, Can Predict Calcification Grade of Abdominal Aortic Aneurysm

“…Lack of biomarkers for risk stratification of patients with AAA impedes development of novel personalized therapies and interventions since, in every patient with a not-yet “surgical” AAA, there are no clear predictors of a fast or slow progression of its own, AAA; that is, the best interval between a radiological check and the next step is not defined. Different authors have suggested a link between risk factors such as smoking history, obesity, glucose tolerance, dyslipidemia, chronic obstructive pulmonary disease, and renal failure and cardiovascular morbidity and mortality, together with some biomarkers such as RBC indices, WBC counts with differentials, platelet counts and neutrophil-to-lymphocyte ratio (NLR), and platelet-to-lymphocyte ratio (PLR), while no evidence exists in the literature about a possible association between AAA calcification and cell blood count (CBC) parameter even if it is a simple economic and extensively used basic hematological test [ 14 – 18 ]. The aim of our study is to evaluate if classical risk factor and biomarkers associated with AAA [ 14 , 15 ] can be associated with AAA calcification grade since an accessible and cost-effective measure such as a blood test predicting subsequent AAA progression in calcification could be used to rule in and/or rule out patients for more expensive MR and CT angiography, with benefit for patients and caregivers and with important reduction of cost.…”

Detection of Pathological Changes in the Aorta during Thoracic Aortic Aneurysm Progression on Molecular Level

“…CRP is mainly expressed by hepatocytes, and its synthesis is regulated at the posttranscriptional level by cytokines, mainly by IL-6 with a synergic effect of IL-1 [ 13 ]. CRP can also be produced locally in atherosclerotic lesions [ 33 ]. A study by De Haro et al [ 34 ] showed that patients with symptomatic and ruptured aneurysms had elevated serum CRP compared with patients with asymptomatic AAA.…”

An Easy Affordable Statistical and Economic (Ease) Approach to Avoid Unnecessary and Expensive Exams to Monitor Patients With Small Aaa

“…The study is conformed to the ethical guidelines of the "World Medical Association Declaration of Helsinki -Ethical Principles for Medical Research Involving Human Subjects" adopted by the 18th World Medical Association General Assembly, Helsinki, Finland, June 1964, and revised in Tokyo in 2004. Institutional ethic committees approved the study, and all patients provided a written informed consent (Ethics Committee of ASST Spedali Civili di Brescia, approval reference number: 1353) [ 7 ]. Participants did not receive any form of financial compensation.…”