Usefulness of Measuring the Serum Elastin Fragment Level in the Diagnosis of an Acute Aortic Dissection.
Previous reports have shown that serum elastin fragments (SEFs) may be a useful biomarker for the diagnosis of an acute aortic dissection (AAD). However, because the reference interval of SEFs has not been established, it has not been determined whether SEFs are really useful for the diagnosis of AAD. The purpose of this study was to determine the usefulness of measuring SEFs for the diagnosis of AAD. A total of 42 consecutive patients aged 68 ± 18 years who were diagnosed with an AAD were studied. Patient background and SEF levels were examined on admission. SEF levels were also measured in patients undergoing a medical examination (n = 531, age 54 ± 17 years) to compare with those with an AAD. In the control group, SEF levels increased with age (R = 0.725, p <0.001). Then, we defined the upper limit of the reference interval of SEF levels as the 97.5th percentile of control SEF grouped by decade of life from the sixth to ninth decade. The overall risk of AAD exceeding the upper limit of the reference interval at each decade was 10% (4 of 42). For patients in their 60s and 70s, median SEF levels in the AAD group (89 [77 to 104], 93 [60 to 123] ng/ml, respectively) were not significantly higher than those in the control group (79 [68 to 92], 90 [79 to 106] ng/ml, respectively; p = 0.081 and 0.990, respectively). Our data suggest that measuring SEF levels may not be useful in the diagnosis of an AAD as the upper limit of the reference interval of the SEF level was unexpectedly higher.
Division of Cardiovascular Intensive Care, Nippon Medical School Hospital, Tokyo, Japan. Electronic address: koichi-a@nms.ac.jp.
Koichi
K
Akutsu
Cardiology and Intensive Care Units, Nippon Medical School Musashi Kosugi Hospital, Kanagawa, Japan; Department of Internal Medicine and Cardiology, Tsurumi University School of Dental Medicine, Kanagawa, Japan.
Hiroyuki
H
Yamanaka
Pharmaceutical Laboratories, Mochida Pharmaceutical Co., Ltd., Shizuoka, Japan.
Masahiko
M
Katayama
Division of Cardiovascular Intensive Care, Nippon Medical School Hospital, Tokyo, Japan.
Takeshi
T
Yamamoto
Department of Cardiovascular Medicine, Nippon Medical School, Tokyo, Japan; Department of Cardiology, Sakakibara Heart Institute, Tokyo, Japan.
Morimasa
M
Takayama
Cardiology and Intensive Care Units, Nippon Medical School Musashi Kosugi Hospital, Kanagawa, Japan.
Motohisa
M
Osaka
Cardiology and Intensive Care Units, Nippon Medical School Musashi Kosugi Hospital, Kanagawa, Japan.
Naoki
N
Sato
Division of Cardiovascular Intensive Care, Nippon Medical School Hospital, Tokyo, Japan; Department of Cardiovascular Medicine, Nippon Medical School, Tokyo, Japan.
Wataru
W
Shimizu
D000208:Acute Disease; D000368:Aged; D000784:Aortic Dissection / Q000175:diagnosis*; D001014:Aortic Aneurysm / Q000175:diagnosis*; D015415:Biomarkers / Q000097:blood; D003937:Diagnosis, Differential; D004549:Elastin / Q000097:blood*; D004797:Enzyme-Linked Immunosorbent Assay; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged
D015415:Biomarkers; D004549:Elastin