Biomarkers of Abdominal Aorta Aneurysm Calcification

Abdominal aortic aneurysm (AAA) is a balloon like dilation found in the distal aorta. Efforts to limit the mortality rate from AAA rupture, that causes approximately 1% of deaths in industrial countries, depend on early detection and elective AAA repair. Even if different authors have demonstrated that risk of rupture increases exponentially with maximal aortic diameter, often reporting the relationship with systemic inflammatory markers, other additional risk factors have already been identified and tested intensively, in particular retrospective studies examining the computed tomography scans of non-ruptured and ruptured AAA patients have positively linked calcification to an increase in AAA rupture. Varying degrees of calcification have been found to exist in most AAA and the risk of rupture is associated with the degree of calcification. Evolution of calcification is often progressive and lack of established prognostic indices making repeat imaging to monitor AAA expansion necessary. Since calcification has been shown to be a sign of a degenerative inflammatory process involved in the arterial wall aim of our study was to identify circulating markers that accurately reflect inflammatory activity or aortic wall calcification that could potentially aid substantially in the identification of appropriate patients for different monitoring protocols and intervention. The study was performed in samples of 83 Caucasian patients admitted to the Surgery Department for AAA resection. Demographic and clinical characteristics of the patients were collected and AAA classified on the basis of the degree of calcification that was correlate with the values of inflammatory markers tested. In particular we evaluate classical inflammation markers such as VES, WBC, fibrinogen and CRP and we found that several biochemical parameters showed a different expression pattern associated with aneurysm calcification and its evolution. The results of our study support the use of some biochemical markers to assess calcification and its progression. They could be used in triaging patients to identify patients who should undergo rapid imaging, thus allowing for prompt initiation of treatment or rule-out suspicious patients from non essential repeat imaging.