Prognostic value of D-dimer and markers of coagulation for stratification of abdominal aortic aneurysm growth
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- Alexandra C. Sundermann
- Vanderbilt Epidemiology Center, Institute of Medicine and Public Health, Vanderbilt University Medical Center, Nashville, TN;
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- Keith Saum
- Division of Cardiovascular Health and Disease,
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- Kelsey A. Conrad
- Division of Cardiovascular Health and Disease,
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- Hannah M. Russell
- Division of Cardiovascular Health and Disease,
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- Todd L. Edwards
- Division of Epidemiology, Department of Medicine, Vanderbilt Genetics Institute, Institute of Medicine and Public Health, Vanderbilt University Medical Center, Nashville, TN; and
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- Kevin Mani
- Section of Vascular Surgery, Department of Surgical Sciences, Uppsala University, Uppsala, Sweden
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- Martin Björck
- Section of Vascular Surgery, Department of Surgical Sciences, Uppsala University, Uppsala, Sweden
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- Anders Wanhainen
- Section of Vascular Surgery, Department of Surgical Sciences, Uppsala University, Uppsala, Sweden
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- A. Phillip Owens
- Division of Cardiovascular Health and Disease,
Abstract
<jats:title>Abstract</jats:title> <jats:p>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-µg/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.</jats:p>
Journal
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- Blood Advances
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Blood Advances 2 (22), 3088-3096, 2018-11-15
American Society of Hematology
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Details 詳細情報について
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- CRID
- 1360298341522954880
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- ISSN
- 24739537
- 24739529
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- Data Source
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- Crossref