Validity of Signal Peptide-CUB-EGF Domain-containing Protein-1 (SCUBE-1) in the Diagnosis of Aortic Dissection

Abstract

Introduction: Diagnosing aortic dissection (AD) in emergency services still represents a challenging issue as it may manifest not only well-known clinical findings such as sudden onset and severe chest pain but also atypical findings similar to ST elevation myocardial infarction or renal colic. Contrast-enhanced imaging investigations, which are expensive and risky due to possible complications, are necessary for diagnosis. Ultrasonography is not always reliable, which necessitates noninvasive diagnostic tests to support a clinical suspicion. Signal peptide-CUB (complement C1r/C1s, Uegf, and Bmp1)-EGF (epidermal growth factor) domain-containing protein 1 (SCUBE-1) is a cell surface protein produced during embryogenesis. This study was conducted to compare the levels of this novel biomarker between patients with AD and healthy volunteers. Methods: This prospective study was conducted on 20 patients diagnosed with AD using contrast-enhanced thoracoabdominal computed tomography angiography. Average age-matched 20 healthy subjects as a control group were included as a reference for biochemical parameters. Results: The mean SCUBE-1 levels were significantly higher in patients with AD [24.51 ( ± 3.01) ng/dL] than in the control group [12.11 ( ± 5.31) ng/dL] (p < 0.001). Receiver-operating characteristic (ROC) curve was plotted to analyze the specificity and sensitivity of AD diagnosis (with 95% confidence intervals), which revealed 95% sensitivity and 76% specificity when the SCUBE-1 level was >19.75 ng/dL.A significant correlation was also observed between dissection types and mortality, as well as extravasation state. Conclusions: This preliminary study demonstrated that plasma SCUBE-1 level is a better and specific biomarker for AD and may be used for diagnosing AD in emergency services. Wider case series and further clinical studies are required to confirm these findings.