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Serum Ceruloplasmin Is the Candidate Predictive Biomarker for Acute Aortic Dissection and Is Related to Thrombosed
Changcheng Ma1, Haibin Zhao2, Feng Shi3
1Department of Laboratory Medicine, Shengjing Hospital of China Medical University, Shenyang, China.
Insights
Serum ceruloplasmin (CP) levels are significantly elevated in patients with acute aortic dissection (AAD). This study suggests CP may be a valuable biomarker for diagnosing AAD and predicting thrombosed false lumen risk.
Area of Science:
- Vascular Surgery
- Biochemistry
- Medical Diagnostics
Background:
- Acute aortic dissection (AAD) is a life-threatening vascular emergency with high early mortality.
- Ceruloplasmin (CP), a copper-transporting protein, has potential roles in inflammatory and cardiovascular conditions.
Purpose of the Study:
- To investigate serum CP levels in patients with AAD.
- To evaluate the diagnostic and prognostic value of CP in AAD.
Main Methods:
- Retrospective study utilizing propensity score matching (PSM) to compare 85 pairs of AAD cases and controls.
- Serum CP levels measured by ELISA.
- Clinical data including inflammatory markers and dissection characteristics analyzed.
Main Results:
- Serum CP levels were significantly higher in AAD patients compared to controls after PSM adjustment.
- CP levels showed a positive correlation with platelet and C-reactive protein.
- Receiver operating characteristic (ROC) analysis indicated CP as a strong diagnostic marker for AAD (AUC = 0.929).
- Elevated CP levels were associated with an increased risk of thrombosed false lumen.
Conclusions:
- Serum CP is significantly elevated in AAD patients.
- CP correlates with inflammatory markers and may serve as a diagnostic biomarker for AAD.
- CP may help identify patients at higher risk for thrombosed false lumen.
Abstract:
Acute aortic dissection (AAD), one of the fatal diseases observed at the department of vascular surgery, is associated with a great mortality rate at the early stage. Ceruloplasmin (CP) is the plasma protein that functions as a copper transporter. The current retrospective research was carried out to assess CP contents and to examine the possible part in diagnosing patients with AAD. In addition, propensity score matching (PSM) was also utilized for reducing the bias in case screening as well as the clinical confounders. Using PSM, this study included 85 pairs of AAD cases (Stanford A and B dissection) and matched controls, and their CP levels were also detected through enzyme-linked immunosorbent assay (ELISA). Additionally, the relative clinical data were extracted from participants included in this study. After PSM adjustment for clinical variables, including gender, age, body mass index (BMI), heart ratio (HR), smoking, hypertension, diabetes mellitus, coronary heart disease (CHD), and stroke, the serum CP contents among AAD cases were remarkably increased compared with those among the normal subjects. Besides, the CP contents showed independent association with the AAD risk. Typically, the CP level was significantly positively correlated with platelet (R = 0.329) or C-reactive protein (R = 0.340) level. Meanwhile, the area under the receiver operating characteristic (ROC) curve (AUC) was 0.929 when CP was used to diagnose AAD, and the best threshold value was 36.82mg/dL. Serum CP content significantly increased in cases with thrombosed false lumen (FL) relative to those in patent FL cases. Results of logistic regression analysis suggested that a greater CP content indicated an increased thrombosed FL risk (OR = 1.11; 95% CI: 1.01-1.23; P = 0.040). Findings in this study suggest that serum ceruloplasmin contents evidently increased among acute aortic dissection cases. CP shows close correlation with the inflammatory factors among AAD cases. Further, CP may serve as the candidate biomarker to diagnose AAD and to identify an increased risk of thrombosed false lumen.
