Asociación de PCR plasmática y evolución del aneurisma de aorta infrarrenal

Abstract

ObjectiveTo assess the association between high sensitivity C-reactive protein (hs-CRP) plasma levels and the prospective progression of aortic abdominal aneurysm (AAA) in order to test its value as a biomarker. Material and methodsProspective cohort of asymptomatic AAA patients followed up in an outpatient clinic since 2008. Clinical data, serial maximum aneurysm diameter (ultrasound and CT) and hs-CRP plasma levels were recorded. Small AAA (30-39mm) were followed up annually, and large AAA (≥40mm) every 6 months. Hs-CRP levels >15mg/L were excluded from the study to avoid acute events acting as potential confounders. Aortic expansion rates were calculated in each follow up period, as well as the difference between aortic diameters in consecutive measurements. Aortic growth was also classified as a dichotomic variable (progression if the growth was >2mm, and stability if the growth was ≤2mm). The Pearson correlation and mixed linear models were used for statistical analysis. ResultsThe study included 218 AAA with a mean baseline diameter of 41.2mm (SD 10.3mm, range 30-90). The average follow up time was 28.8 months (SD 13.7, range 4.8-62) and the mean baseline hs-CRP level was 4.1mg/dL (SD 3.3, range 0.5-15). A significant association was observed between hs-CRP levels and baseline AAA diameter (r=0.23, P=.001), and this association was maintained over serial determinations throughout the follow-up (P<.0001). No statistically significant association was observed between hs-CRP concentrations and aortic growth rates, measured as a continuous variable (P=.10). However, increasing hs-CRP levels were associated with AAA progression [(OR=1.008; 95% (1.000-1.016) P=.04)]. Conclusionshs-CRP plasma levels are consistently associated with AAA diameter throughout the follow-up of the patients, and increased levels are associated with AAA progression.