APC-PCI complex levels for screening of AAA in patients with peripheral atherosclerosis.
To evaluate the use of activated protein C-protein C inhibitor (APC-PCI) complex levels for detection of abdominal aortic aneurysm (AAA) in patients with peripheral atherosclerotic disease (PAD). APC-PCI levels and aortic diameter evaluated in 511 PAD patients without previously known AAA followed-up concerning survival for 4.8(0.5) years. AAA was found in 13% of patients. Aortic diameter correlated (r = 0.138; p = 0.002) with APC-PCI levels which were higher (0.40[0.45] vs. 0.30[0.49] μg/l; p = 0.004) in patients with AAA. This difference persisted in multivariate analysis (p = 0.029). A threshold value of APC-PCI ≥0.15 μg/L showed a specificity of 11%, a sensitivity of 97% and a negative predictive value of 96% for an AAA diagnosis. APC-PCI levels were higher in patients with AAA, and showed high sensitivity but low specificity for the diagnosis and can therefore not be considered as a screening tool in PAD patients. An AAA prevalence of 13% in patients with PAD indicates a need for AAA screening within this population.
Department of Vascular Diseases, Skåne University Hospital, S-205 02, Malmö, Sweden, moncef.zarrouk@med.lu.se.
Moncef
M
Zarrouk
Kave
K
Keshavarz
Bengt
B
Lindblad
Anders
A
Gottsäter
D000368:Aged; D000369:Aged, 80 and over; D001012:Aorta, Abdominal / Q000378:metabolism / Q000473:pathology; D017544:Aortic Aneurysm, Abdominal / Q000097:blood* / Q000401:mortality* / Q000473:pathology; D018572:Disease-Free Survival; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D008875:Middle Aged; D015995:Prevalence; D011486:Protein C / Q000378:metabolism*; D018046:Protein C Inhibitor / Q000097:blood*; D012189:Retrospective Studies; D015996:Survival Rate
D011486:Protein C; D018046:Protein C Inhibitor