Markers of inflammation in men with small abdominal aortic aneurysm.
BACKGROUND
Markers of inflammation and fibrin turnover are elevated in individuals with a large (>55 mm) abdominal aortic aneurysm (AAA). Fibrin degradation generates D-dimer, known to possess multiple proinflammatory effects, and levels are elevated during early AAA development. This study characterized the plasma inflammatory response during early AAA pathogenesis to determine the effect of D-dimer levels.


METHODS
The study compared 75 men with a small AAA (range, 30-54 mm) with 90 age-, sex-, and race-matched controls. Plasma interleukin-6 (IL-6), complement C3, high-sensitivity C-reactive protein (hsCRP), fibrinogen, and D-dimer levels were measured.


RESULTS
Mean levels of fibrinogen (2.92 vs 2.59 g/L; P = .003), hsCRP (2.07 vs 1.29 ng/mL; P = .005), and D-dimer (346.7 vs 120.2 ng/mL; P < .001) were higher in men with a small AAA. These markers correlated with maximum aortic diameter determined by ultrasound imaging. On multivariate analysis, D-dimer levels were elevated in AAA individuals independent of smoking, cardiovascular disease (CVD), atherosclerotic risk factors, and inflammatory parameters. Fibrinogen and hsCRP levels remained elevated after adjustment for these covariates but lost significance when D-dimer was added to the model.


CONCLUSIONS
C-reactive protein and D-dimer levels are elevated during early AAA development. D-dimer levels are most tightly associated with AAA status, however, and may mediate the observed elevation in acute-phase reactants.
Parry
Duncan J
DJ
Division of Cardiovascular and Diabetes Research, Section on Mechanisms of Thrombosis, University of Leeds, Leeds, West Yorkshire, United Kingdom.
Al-Barjas
Hamad S
HS
Chappell
Louise
L
Rashid
S Tawqeer
ST
Ariëns
Robert A S
RA
Scott
D Julian A
DJ
D000368:Aged; D017544:Aortic Aneurysm, Abdominal / Q000097:blood / Q000000981:diagnostic imaging / Q000276:immunology*; D015415:Biomarkers / Q000097:blood; D002097:C-Reactive Protein / Q000032:analysis; D016022:Case-Control Studies; D016009:Chi-Square Distribution; D003176:Complement C3 / Q000032:analysis; D005338:Fibrin Fibrinogen Degradation Products / Q000032:analysis; D005340:Fibrinogen / Q000032:analysis; D006801:Humans; D018836:Inflammation Mediators / Q000097:blood*; D015850:Interleukin-6 / Q000097:blood; D016014:Linear Models; D008297:Male; D014463:Ultrasonography; D015854:Up-Regulation
D015415:Biomarkers; D003176:Complement C3; D005338:Fibrin Fibrinogen Degradation Products; C508600:IL6 protein, human; D018836:Inflammation Mediators; D015850:Interleukin-6; C036309:fibrin fragment D; D005340:Fibrinogen; D002097:C-Reactive Protein