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Neutrophil Elastase-Derived Fibrin Degradation Products Indicate Presence of Abdominal Aortic Aneurysms and Correlate with Intraluminal Thrombus Volume
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2018 (English)In: Thrombosis and Haemostasis, ISSN 0340-6245, Vol. 118, no 2, p. 329-339Article in journal (Refereed) Published
Abstract [en]

Background The intraluminal thrombi (ILT) of abdominal aortic aneurysms (AAA) contain neutrophils, which can secrete elastase. We evaluated whether plasma neutrophil elastase-derived cross-linked fibrin degradation products (E-XDP) could reveal the presence, size and mechanical stress of AAAs and its ILTs. Methods E-XDP and D-dimer were measured in plasma from 37 male patients with AAA and 42 male controls. The ILT volumes of the AAAs and any coexisting aneurysms could be measured in 29 patients and finite element analysis was performed to estimate mechanical stress of the ILT. E-XDP, neutrophil elastase and neutrophil marker CD66acd were evaluated in aortic tissue with immunohistochemistry (IHC). The association between ILT volume and E-XDP was validated in a separate cohort (n = 51). Results E-XDP levels were elevated in patients with AAA compared with controls (p = 5.8e-13), indicated AAA with 98% sensitivity, 86% specificity and increased with presence of coexisting aneurysms. The association between AAA and increased E-XDP was independent of smoking, comorbidities and medication. E-XDP correlated with volume of all ILTs (r = 0.76, p = 4.5e-06), mean ILTstress (r = 0.46, p = 0.013) and the volume of the AAA-associated ILT (r = 0.64, p = 0.00017). E-XDP correlated stronger with ILT volume compared with D-dimer (r = 0.76 vs. r = 0.64, p = 0.018). The correlation between E-XDP and ILT volume was validated in the separate cohort (r = 0.53, p = 7.6e-05). IHC revealed E-XDP expression in the ILT, spatially related to neutrophil elastase and neutrophils. Conclusion E-XDP is a marker of the presence of AAA and coexisting aneurysms as well as the volume and mechanical stress of the ILT.

Place, publisher, year, edition, pages
Schattauer GmbH Verlag für Medizin und Naturwissenschaften , 2018. Vol. 118, no 2, p. 329-339
Keywords [en]
thrombus, leukocyte elastase, aortic aneurysm, abdominal, finite element analysis, computed tomography
National Category
Cardiac and Cardiovascular Systems
Identifiers
URN: urn:nbn:se:kth:diva-223278DOI: 10.1160/TH17-05-0348ISI: 000423998900009OAI: oai:DiVA.org:kth-223278DiVA, id: diva2:1183335
Funder
Swedish Heart Lung Foundation, 20160266 20150529 20140722 20140811 20130657Swedish Research Council, 2016-0176 2015-04476
Note

QC 20180216

Available from: 2018-02-16 Created: 2018-02-16 Last updated: 2018-02-16Bibliographically approved

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Gasser, T. Christian

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