Circulating Biomarkers for the Prediction of Abdominal Aortic Aneurysm Growth

Abstract

Background: Abdominal aortic aneurysm represents a distinct group of vascular lesions, in terms of surveillance and treatment. Screening and follow-up of patients via duplex ultrasound has been well established and proposed by current guidelines. However, serum circulating biomarkers could earn a position in individualized patient surveillance, especially in cases of aggressive AAA growth rates. A systematic review was conducted to assess the correlation of AAA expansion rates with serum circulating biomarkers. Methods: A data search of English medical literature was conducted, using PubMed, EMBASE, and CENTRAL, until 7 March 2021, in accordance with the Preferred Reporting Items for Systematic Reviews and Meta-Analysis statement (PRISMA) guidelines. Studies reporting on humans, on abdominal aortic aneurysm growth rates and on serum circulating biomarkers were included. No statistical analysis was conducted. Results: A total of 25 studies with 4753 patients were included. Studies were divided in two broad categories: Those reporting on clinically applicable (8 studies) and those reporting on experimental (17 studies) biomarkers. Twenty-three out of 25 studies used duplex ultrasound (DUS) for following patients. Amongst clinically applicable biomarkers, D-dimers, LDL-C, HDL-C, TC, ApoB, and HbA1c were found to bear the most significant association with AAA growth rates. In terms of the experimental biomarkers, PIIINP, osteopontin, tPA, osteopontin, haptoglobin polymorphisms, insulin-like growth factor I, thioredoxin, neutrophil extracellular traps (NETs), and genetic factors, as polymorphisms and microRNAs were positively correlated with increased AAA expansion rates. Conclusion: In the presence of future robust data, specific serum biomarkers could potentially form the basis of an individualized surveillance strategy of patients presenting with increased AAA growth rates.

Relationship between the Levels of Calprotectin and Soluble Receptor for Advanced Glycation End Products with Abdominal Aortic Aneurysm Diameter: A Preliminary Clinical Trial

“…The markers mentioned above have not been studied in detail for correlation with AAA diameter so far; hence, there is a limited number of studies on this subject, making it difficult to discuss. In their systematic review, Nana et al [19] highlighted that circulating serum biomarkers may have applicability in individualized patient surveillance, especially in cases of aggressive AAA growth. There is an urgent need for further studies to obtain reliable data that provide evidence for specific serum biomarkers, potentially informing an individualized surveillance strategy for patients with increased AAA growth.…”

Imaging Predictive Factors of Abdominal Aortic Aneurysm Growth

“…However, no association between imaging findings and blood circulating markers has been detected in the available studies [ 21 ]. Further analyses and novel approaches are needed to assess the role of the available imaging and biochemical entities on aneurysm progression [ 55 , 56 , 57 ].…”

Recent Developments in Clinical Plasma Proteomics—Applied to Cardiovascular Research

“…A range of other circulating protein biomarkers for AAA have been investigated. None of them have, however, been shown to be useful in diagnosing and predicting AAA growth [ 105 ], and new proteomics studies in larger cohorts are, therefore, needed to find clinically useful AAA plasma biomarkers for screening and stratification purposes.…”