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High plasma microfibrillar-associated protein 4 is associated with reduced surgical repair in abdominal aortic
Jes Sanddal Lindholt1, Mathilde Madsen2, Katrine Lindequist Kirketerp-Møller2
1Cardiovascular Research Unit, Viborg Hospital, Viborg, Denmark.
Objective:
Identifying biomarkers for abdominal aortic aneurysms (AAA) could prove beneficial in prognosis of AAA and thus the selection for treatment. Microfibrillar-associated protein 4 (MFAP4) is an extracellular matrix protein that is highly expressed in aorta. MFAP4 is involved in several tissue remodeling-related diseases. We aimed to investigate the potential role of plasma MFAP4 (pMFAP4) as a biomarker of AAA.
Methods:
Plasma samples and data were obtained for 504 male AAA patients and 188 controls in the Viborg Vascular (VIVA) screening trial. The pMFAP4 levels were measured by Alphalisa. The Mann-Whitney U test assessed differences in pMFAP4 levels between the presence and absence of different exposures of interest. The correlation between pMFAP4 and aorta growth rate were investigated through spearman's correlation analysis. Immunohistochemistry and multiple logistic regression adjusted for potential confounders assessed the association between pMFAP4 and AAA. Multiple linear regression assessed the correlation between pMFAP4 and aorta growth rate. Cox regression and competing risk regression were used to investigate the correlation between AAA patients with upper tertile pMFAP4 and the risk of undergoing later surgical repair.
Results:
A significant negative correlation between pMFAP4 and aorta growth rate was observed using spearman's correlation analysis (ρ = -0.14; P = .0074). However, this finding did not reach significance when applying multiple linear regression. A tendency of decreased pMFAP4 was observed in AAA using immunohistochemistry. Competing risk regression adjusted for potential confounders indicated that patients with upper tertile pMFAP4 had a hazard ratio of 0.51 (P = .001) for risk of undergoing later surgical repair.
Conclusions:
High levels of pMFAP4 are associated with a decreased likelihood of receiving surgical repair in AAA. This observation warrants confirmation in an independent cohort.
Insights
Plasma microfibrillar-associated protein 4 (pMFAP4) may serve as a biomarker for abdominal aortic aneurysms (AAA). High pMFAP4 levels are linked to a lower chance of AAA surgical repair, suggesting a potential prognostic role.
Area of Science:
- Biochemistry
- Vascular Biology
- Biomarker Discovery
Background:
- Abdominal aortic aneurysms (AAA) require effective biomarkers for prognosis and treatment selection.
- Microfibrillar-associated protein 4 (MFAP4) is an extracellular matrix protein highly expressed in the aorta and implicated in tissue remodeling diseases.
Purpose of the Study:
- To investigate the potential of plasma MFAP4 (pMFAP4) as a diagnostic and prognostic biomarker for AAA.
- To assess the association between pMFAP4 levels and AAA progression and the need for surgical intervention.
Main Methods:
- Analysis of plasma samples from 504 male AAA patients and 188 controls.
- Measurement of pMFAP4 levels using Alphalisa.
- Statistical analyses including Mann-Whitney U test, Spearman's correlation, multiple logistic regression, and competing risk regression.
Main Results:
- A significant negative correlation was observed between pMFAP4 and aorta growth rate (Spearman's ρ = -0.14, P = .0074), though not significant in multiple linear regression.
- Immunohistochemistry suggested a tendency for decreased pMFAP4 in AAA.
- Competing risk regression revealed that patients in the upper tertile of pMFAP4 had a 51% reduced risk of undergoing later surgical repair (HR = 0.51, P = .001).
Conclusions:
- Elevated plasma MFAP4 levels are associated with a reduced likelihood of surgical repair in patients with abdominal aortic aneurysms.
- These findings suggest pMFAP4 may have a role in the prognosis of AAA, warranting further validation in independent cohorts.
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