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Serum elastin peptides in the preoperative evaluation of abdominal aortic aneurysms
J S Lindholt1, H A Ashton, L Heickendorff
1Department of Vascular Surgery, Rigshospitalet, Copenhagen, Denmark.
Objective:
Serum elastin peptides (SEP) have been reported to be associated with the expansion of small abdominal aortic aneurysms (AAA). Consequently, SEP-measurements may predict future rupture, and allow further selection for surgery in cases referred for surgery due to size.
Material And Methods:
SEP was measured in 90 men and 10 women with AAA, who were considered for surgery as part of the Chichester aneurysm screening programme. Sixty-one patients were electively operated and four because of symptoms. The rest were followed up further. Twelve of these experienced ruptured AAA later.
Results:
No correlation between last measured AAA-diameter, annual expansion rate and SEP was noticed. However, SEP levels were significantly higher in cases rupturing later, persisting after adjustment for age, sex, and last measured AAA-size. ROC curve analysis concerning SEP as a predictor of rupture later showed an optimal sensitivity and specificity of 67% and 60%, respectively, similar with last measured AAA-size. By combining AAA-size and SEP, the optimal sensitivity and specificity reached 83% and 66%, respectively.
Conclusion:
One sampling of SEP combined with AAA-size in patients referred for AAA surgery may be a clinical useful indicator of high rupture risk.