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Prognostic value of D-dimer and markers of coagulation for stratification of abdominal aortic aneurysm growth
Vanderbilt Univ, Med Ctr, Inst Med & Publ Hlth, Vanderbilt Epidemiol Ctr, Nashville, TN USA.
Univ Cincinnati, Coll Med, Dept Internal Med, Div Cardiovasc Hlth & Dis, Cincinnati, OH 45267 USA;Univ Cincinnati, Coll Med, Dept Internal Med, Med Scientist Training Program, Cincinnati, OH 45267 USA.
Univ Cincinnati, Coll Med, Dept Internal Med, Div Cardiovasc Hlth & Dis, Cincinnati, OH 45267 USA;Univ Cincinnati, Coll Med, Dept Internal Med, Pathobiol & Mol Med Grad Program, Cincinnati, OH 45267 USA.
Univ Cincinnati, Coll Med, Dept Internal Med, Div Cardiovasc Hlth & Dis, Cincinnati, OH 45267 USA;Univ Cincinnati, Coll Med, Dept Internal Med, Pathobiol & Mol Med Grad Program, Cincinnati, OH 45267 USA.
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2018 (English)In: BLOOD ADVANCES, ISSN 2473-9529, Vol. 2, no 22, p. 3088-3096Article in journal (Refereed) Published
Abstract [en]

Abdominal aortic aneurysm (AAA) is associated with high morbidity and mortality and is an established cause of unbalanced hemostasis. A number of hemostatic biomarkers have been associated with AAA; however, the utility of hemostatic biomarkers in AAA diagnosis and prognosis is unclear. The aim of the present study was to characterize the potential prognostic value of D-dimer and markers of altered hemostasis in a large cohort of patients with AAAs characterized by either fast or slow aneurysm growth (frequency matched for baseline diameter) and subaneurysmal dilations. We measured plasma concentrations of thrombin-antithrombin (TAT) complex, platelet factor 4 (PF4), and D-dimer in 352 patients with either fast-growing AAAs (>2 mm/y), slow-growing AAAs (<2 mm/y), subaneurysmal aortic dilations, or nonaneurysmal aortas. Plasma D-dimer and TAT were significantly elevated in both AAA and subaneurysmal dilation patients compared with controls. Individuals with D-dimer levels >= 500 ng/mL had 3.09 times the odds of subaneurysms, 6.23 times the odds of slow-growing AAAs, and 7.19 times the odds of fast-growing AAAs than individuals with D-dimer level <500 ng/mL. However, no differences in D-dimer concentration were noted between fast- and slow-growing aneurysms. Plasma D-dimer and TAT were strong independent predictors of AAA growth rate with multivariate analysis revealing a 500-ng/mL increase in D-dimer or 1-mu g/mL increase in TAT led to additional 0.21-mm and 0.24-mm changes in aortic diameter per year, respectively. Rising levels of plasma TAT, in addition to D-dimer, may predict disease progression and aneurysm growth in patients with AAA or subaneurysmal dilation.

Place, publisher, year, edition, pages
2018. Vol. 2, no 22, p. 3088-3096
National Category
Cardiac and Cardiovascular Systems
Identifiers
URN: urn:nbn:se:uu:diva-372446DOI: 10.1182/bloodadvances.2017013359ISI: 000451417500001PubMedID: 30442686OAI: oai:DiVA.org:uu-372446DiVA, id: diva2:1275864
Funder
Swedish Research Council, K2013-64X-20406-07-3Swedish Research Council, K2013-99X-22275-01-3Swedish Heart Lung Foundation, 2012-0353Swedish Heart Lung Foundation, 2015-0596Available from: 2019-01-07 Created: 2019-01-07 Last updated: 2019-01-07Bibliographically approved

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Mani, KevinBjörck, MartinWanhainen, Anders

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