Potential Circulating Biomarkers for Abdominal Aortic Aneurysm Expansion and Rupture - a Systematic Review

Urbonavičius, Sigitas; Urbonavičienė, Gražina; Honoré, Bent; Henneberg, E W; Vorum, Henrik; Lindholt, Jes Sanddal

doi:10.1016/j.ejvs.2008.05.009

Cited by 100 publications

(36 citation statements)

References 45 publications

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“…Accordingly, there is a considerable body of work documenting hypothesis-based biomarker discovery investigations for AAA. This area has recently been reviewed,8,36,37,123 thus we will briefly discuss the techniques used to assess putative biomarkers and illustrate with appropriate examples.…”

Section: 0 Future Prospects Of Aaa Diagnosis and Monitoringmentioning

confidence: 99%

“…In addition to this, the mural thrombus has been identified as a site for polymorphonuclear leukocyte accumulation and protease activation and release,29,32 suggesting that biochemical processes outside the arterial wall may contribute to AAA development. Several MMPs including MMP-1, -2, -3 and -9 have been proposed as putative markers for AAA 8,123. However, poor correlation between circulating MMP titres and vascular phenotype suggests that these are unreliable sentinels with which to stratify AAA patients 138–140.…”

Section: 0 Future Prospects Of Aaa Diagnosis and Monitoringmentioning

confidence: 99%

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Diagnosis and Monitoring of Abdominal Aortic Aneurysm: Current Status and Future Prospects

Moxon

Parr²,

Emeto³

et al. 2010

Current Problems in Cardiology

127

148

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Abdominal aortic aneurysm (AAA) remains an important cause of morbidity and mortality in elderly men, and prevalence is predicted to increase in parallel with a global ageing population. AAA is commonly asymptomatic, and in the absence of routine screening, diagnosis is usually incidental when imaging to assess unrelated medical complaints. In the absence of approved diagnostic and prognostic markers, AAAs are monitored conservatively via medical imaging until aortic diameter approaches 50-55mm and surgical repair is performed. There is currently significant interest in identifying molecular markers of diagnostic and prognostic value for AAA. Here we outline the current guidelines for AAA management, and discuss modern scientific techniques currently employed to identify improved diagnostic and prognostic markers. KeywordsAbdominal aortic aneurysm; diagnosis; prognosis; biomarker INTRODUCTIONAn abdominal aortic aneurysm (AAA) is a dilation of the infra-renal aorta, which appears to result from chronic weakening of the arterial wall, increasing the risk of fatal rupture.1 -3 AAA is also associated with an increased risk of other major cardiovascular events in aneurysmal patients. For example the UK small aneurysm trial (UKSAT), demonstrated that only 16% of deaths in patients with 40-55mm AAAs was related to AAA repair or rupture while ~50% were due to other cardiovascular causes (mainly myocardial infarction and stroke).4 Publisher's Disclaimer: This is a PDF file of an unedited manuscript that has been accepted for publication. As a service to our customers we are providing this early version of the manuscript. The manuscript will undergo copyediting, typesetting, and review of the resulting proof before it is published in its final citable form. Please note that during the production process errors may be discovered which could affect the content, and all legal disclaimers that apply to the journal pertain. NIH Public Access AAA pathologyMacroscopically, an AAA can be considered a dilatation of the infrarenal aorta, giving rise to a permanent vessel diameter >30mm (typical abdominal aortic diameter ranges from 15 to 25mm). 23-27 AAA vessel dilation is commonly progressive, and is often accompanied by the formation of a laminated, non-occlusive, intraluminal thrombus.28 -29 Thrombus size and location varies between patients, and the arterial wall may be partially or completely covered by the thrombus ( Figure 1A and B). 30 The thrombus remains in permanent contact with circulating blood and is continually remodeled, 31,32 and thrombus size increases in parallel with aortic dilation. Due to constant remodeling the thrombus is a laminated structure comprising a red blood cell-rich luminal layer in contact with the flowing blood, progressing to a brown fibrinolysed layer at the aortic wall. 29 Localised hypoxia has been demonstrated in regions of the aorta covered by the thrombus and this has been suggested to contribute to physiological stresses within the arterial wall. 33 Similar to other vascular dise...

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Section: 0 Future Prospects Of Aaa Diagnosis and Monitoringmentioning

confidence: 99%

Section: 0 Future Prospects Of Aaa Diagnosis and Monitoringmentioning

confidence: 99%

Diagnosis and Monitoring of Abdominal Aortic Aneurysm: Current Status and Future Prospects

Moxon

Parr²,

Emeto³

et al. 2010

Current Problems in Cardiology

127

148

View full text Add to dashboard Cite

show abstract

“…All the references from the identified articles were searched for relevant information. The starting date was January 2008, since, previously, bibliography was covered by the review of Urbonavicius et al [17] and the end date of the review was April 2014. We focused on human studies that reported the presence of aneurysm, size, expansion rates, and risk of rupture and on new biomarkers and their potential value relevant to the management of AAA.…”

Section: Methodsmentioning

confidence: 99%

“…It is known that this risk increases when the observed expansion rate is greater than the expected [16]. Furthermore, a biomarker could define the optimal surveillance intervals and possibly identify pathogenic pathways which could guide monitoring and treatment [17]. We should not fail to mention that, in order for a biomarker to be employed in modern healthcare system, its use should be cost-effective.…”

Section: Introductionmentioning

confidence: 99%

Novel Biomarkers of Abdominal Aortic Aneurysm Disease: Identifying Gaps and Dispelling Misperceptions

Moris

Mantonakis

Avgerinos

et al. 2014

BioMed Research International

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Abdominal aortic aneurysm (AAA) is a prevalent and potentially life-threatening disease. Early detection by screening programs and subsequent surveillance has been shown to be effective at reducing the risk of mortality due to aneurysm rupture. The aim of this review is to summarize the developments in the literature concerning the latest biomarkers (from 2008 to date) and their potential screening and therapeutic values. Our search included human studies in English and found numerous novel biomarkers under research, which were categorized in 6 groups. Most of these studies are either experimental or hampered by their low numbers of patients. We concluded that currently no specific laboratory markers allow screeing for the disease and monitoring its progression or the results of treatment. Further studies and studies in larger patient groups are required in order to validate biomarkers as cost-effective tools in the AAA disease.

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“…The infiltrates are also abundant with pro-inflammatory cytokines such as prostaglandin E2 (PGE2) and interleukin 6 (IL6) 13. Furthermore, concentrations of circulating cytokines, such as interferon γ, have been associated with AAA expansion and rupture 14. Many factors may initiate the inflammatory response.…”

Section: Pathophysiology Of Aaa Growthmentioning

confidence: 99%

Role of medical intervention in slowing the growth of small abdominal aortic aneurysms

Cooper

King

Earnshaw

2009

Postgraduate Medical Journal

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Abdominal aortic aneurysm is a common-but preventable-cause of death in elderly men; 4% of men at the age of 65 years have an aorta >3 cm in diameter. Continued expansion runs the risk of aneurysm rupture, a condition that is fatal in all but 15% of individuals. A national screening programme has commenced that aims to reduce the number of deaths from aneurysm rupture by 50%. The programme will detect a large number of men with a small aneurysm who are not in imminent danger of rupture, but who will join a regular ultrasound programme of surveillance. If the aneurysm expansion rate could be reduced, fewer men would be at risk of aneurysm rupture, and fewer would need elective aneurysm repair. A considerable amount is known about the pathophysiology of aneurysm growth. Exploring pharmacological means to delay or reduce aneurysm growth could make a considerable contribution to any screening programme. A number of case control studies have suggested that some antihypertensive drugs, non-steroidal anti-inflammatory drugs, antibiotics, and statins may reduce aneurysm growth rates. Data from controlled studies have provided less secure conclusions. Use of these medications, together with lifestyle modification such as stopping smoking, could become standard advice to men with a small aortic aneurysm. Further studies of novel agents and larger controlled trials of existing drugs are warranted.

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Potential Circulating Biomarkers for Abdominal Aortic Aneurysm Expansion and Rupture - a Systematic Review

Cited by 100 publications

References 45 publications

Diagnosis and Monitoring of Abdominal Aortic Aneurysm: Current Status and Future Prospects

Diagnosis and Monitoring of Abdominal Aortic Aneurysm: Current Status and Future Prospects

Novel Biomarkers of Abdominal Aortic Aneurysm Disease: Identifying Gaps and Dispelling Misperceptions

Role of medical intervention in slowing the growth of small abdominal aortic aneurysms

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