Serum elastin peptides in the preoperative evaluation of abdominal aortic aneurysms.
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.


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.


CONCLUSIONS
One sampling of SEP combined with AAA-size in patients referred for AAA surgery may be a clinical useful indicator of high rupture risk.
Lindholt
J S
JS
Department of Vascular Surgery, Rigshospitalet, Copenhagen, Denmark.
Ashton
H A
HA
Heickendorff
L
L
Scott
R A
RA
D000368:Aged; D000369:Aged, 80 and over; D017544:Aortic Aneurysm, Abdominal / Q000097:blood / Q000473:pathology* / Q000601:surgery; D001019:Aortic Rupture / Q000097:blood / Q000175:diagnosis; D015415:Biomarkers / Q000097:blood; D004549:Elastin / Q000097:blood*; D005260:Female; D006801:Humans; D008297:Male; D010455:Peptides / Q000097:blood*; D011237:Predictive Value of Tests; D011300:Preoperative Care; D012372:ROC Curve; D012680:Sensitivity and Specificity
D015415:Biomarkers; D010455:Peptides; D004549:Elastin