1
|
Chan DYC, Chan DTM, Sun TFD, Ng SCP, Wong GKC, Poon WS. The use of atorvastatin for chronic subdural haematoma: a retrospective cohort comparison study. Br J Neurosurg 2016; 31:72-77. [DOI: 10.1080/02688697.2016.1208806] [Citation(s) in RCA: 31] [Impact Index Per Article: 3.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/15/2022]
Affiliation(s)
- David Yuen Chung Chan
- Division of Neurosurgery, Department of Surgery, Prince of Wales Hospital, the Chinese University of Hong Kong, Hong Kong
| | - Danny Tat Ming Chan
- Division of Neurosurgery, Department of Surgery, Prince of Wales Hospital, the Chinese University of Hong Kong, Hong Kong
| | - Tin Fung David Sun
- Division of Neurosurgery, Department of Surgery, Prince of Wales Hospital, the Chinese University of Hong Kong, Hong Kong
| | - Stephanie Chi Ping Ng
- Division of Neurosurgery, Department of Surgery, Prince of Wales Hospital, the Chinese University of Hong Kong, Hong Kong
| | - George Kwok Chu Wong
- Division of Neurosurgery, Department of Surgery, Prince of Wales Hospital, the Chinese University of Hong Kong, Hong Kong
| | - Wai Sang Poon
- Division of Neurosurgery, Department of Surgery, Prince of Wales Hospital, the Chinese University of Hong Kong, Hong Kong
| |
Collapse
|
2
|
Nguyen V, Leiner T, Hellenthal F, Backes W, Wishaupt M, van der Geest R, Heeneman S, Kooi M, Schurink G. Abdominal Aortic Aneurysms with High Thrombus Signal Intensity on Magnetic Resonance Imaging are Associated with High Growth Rate. Eur J Vasc Endovasc Surg 2014; 48:676-84. [DOI: 10.1016/j.ejvs.2014.04.025] [Citation(s) in RCA: 28] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/06/2013] [Accepted: 04/16/2014] [Indexed: 10/25/2022]
|
3
|
Zarrouk M, Keshavarz K, Lindblad B, Gottsäter A. APC-PCI complex levels for screening of AAA in patients with peripheral atherosclerosis. J Thromb Thrombolysis 2014; 36:495-500. [PMID: 23354969 DOI: 10.1007/s11239-013-0871-6] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/27/2022]
Abstract
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.
Collapse
Affiliation(s)
- Moncef Zarrouk
- Department of Vascular Diseases, Skåne University Hospital, S-205 02, Malmö, Sweden,
| | | | | | | |
Collapse
|
4
|
Qin Y, Cao X, Yang Y, Shi GP. Cysteine protease cathepsins and matrix metalloproteinases in the development of abdominal aortic aneurysms. Future Cardiol 2013; 9:89-103. [PMID: 23259477 DOI: 10.2217/fca.12.71] [Citation(s) in RCA: 25] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/15/2022] Open
Abstract
Both cysteine protease cathepsins and matrix metalloproteinases are implicated in the pathogenesis of abdominal aortic aneurysms (AAAs) in humans and animals. Blood and aortic tissues from humans or animals with AAAs contain much higher levels of these proteases, and often lower levels of their endogenous inhibitors, than do blood and aortic tissues from healthy subjects. Protease- and protease inhibitor-deficient mice and synthetic protease inhibitors have affirmed that cysteinyl cathepsins and matrix metalloproteinases both participate directly in AAA development in several experimental model systems. Here, we summarize our current understanding of how proteases contribute to the pathogenesis of AAA, and discuss whether proteases or their inhibitors may serve as diagnostic biomarkers or potential therapeutic targets for this common human arterial disease.
Collapse
Affiliation(s)
- Yanwen Qin
- The Key Laboratory of Remodeling-Related Cardiovascular Diseases, Beijing An Zhen Hospital, Capital Medical University, Ministry of Education, Beijing Institute of Heart, Lung & Blood Vessel Diseases, Beijing 100029, China
| | | | | | | |
Collapse
|
5
|
Association of statin prescription with small abdominal aortic aneurysm progression. Am Heart J 2010; 159:307-13. [PMID: 20152231 DOI: 10.1016/j.ahj.2009.11.016] [Citation(s) in RCA: 128] [Impact Index Per Article: 9.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/25/2009] [Accepted: 11/18/2009] [Indexed: 11/20/2022]
Abstract
BACKGROUND Statins have been suggested to reduce expansion of abdominal aortic aneurysms (AAAs) independent of lipid-lowering effects. METHODS We assessed the association of statin treatment and serum low-density lipoprotein (LDL) concentrations with small AAA expansion. Six hundred fifty-two patients undergoing surveillance of small AAAs were entered into the study from 5 vascular centers. In a subset, fasting lipids (n = 451) and other biomarkers (n = 216) were measured. The AAA diameter was followed by ultrasound surveillance for a median of 5 years. RESULTS Three hundred forty-nine (54%) of the patients were prescribed statins. Adjusting for other risk factors, statin prescription was not associated with AAA growth (odds ratio [OR] 1.23, 95% CI 0.86-1.76). Above-median AAA growth was positively associated with initial diameter (OR 1.78 per 4.35-mm-larger initial aortic diameter, 95% CI 1.49-2.14) and negatively associated with diabetes (OR 0.37, 95% CI 0.22-0.62). Above-median serum LDL concentration was not associated with AAA growth. Patients receiving statins had lower serum C-reactive protein concentrations but similar matrix metalloproteinase-9 and interleukin-6 concentrations to those not prescribed these medications. CONCLUSIONS We found no association between statin prescription or LDL concentration with AAA expansion. The results do not support the findings of smaller studies and suggest that statins may have no benefit in reducing AAA progression.
Collapse
|
6
|
Schweitzer M, Mitmaker B, Obrand D, Sheiner N, Abraham C, Dostanic S, Meilleur M, Sugahara T, Chalifour LE. Atorvastatin Modulates Matrix Metalloproteinase Expression, Activity, and Signaling in Abdominal Aortic Aneurysms. Vasc Endovascular Surg 2009; 44:116-22. [DOI: 10.1177/1538574409348352] [Citation(s) in RCA: 29] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/17/2023]
Abstract
Statins may reduce abdominal aortic aneurysm (AAA) progression. We sought to measure how atorvastatin (AT) treatment might modulate matrix metalloproteinase (MMP) expression and/or activity in human AAA. Tissue from human AAAs at surgical repair was obtained from patients who were either not on statins (NST, n = 19) or treated with AT (n = 19). Immunoblots measured expression and zymography measured activity. Expression of most proteins was greater in the central compared with distal AAA region. Matrix metalloproteinase 1, MMP2, MMP3, MMP9, Tissue Inhibitor of Metalloproteinase (TIMP2), TIMP3, TIMP4, or total Sma Mothers Against Decapentaplegia (SMAD2) expression did not differ with treatment. There was a trend toward reduced MMP8 and TIMP1 expression and MMP2 zymographic activity in the AT-treatment group. In contrast, AT-treated samples had significantly reduced MMP13 (P = .02), latent-transforming growth factor (TGF)-β (P = .02), and phospho-SMAD2 (P = .029) expression than NST-treated samples. We conclude that the AT-mediated decrease in MMP expression and activity reduces TGF-β signaling in the central region of human AAAs.
Collapse
Affiliation(s)
- Morris Schweitzer
- Department of Endocrinology, Sir Mortimer B. Davis-Jewish General Hospital, Montreal, Quebec, Canada,
| | - Benjamin Mitmaker
- Department of Surgery, Sir Mortimer B. Davis-Jewish General Hospital, Montreal, Quebec, Canada
| | - Daniel Obrand
- Department of Surgery, Sir Mortimer B. Davis-Jewish General Hospital, Montreal, Quebec, Canada
| | - Nathan Sheiner
- Department of Surgery, Sir Mortimer B. Davis-Jewish General Hospital, Montreal, Quebec, Canada
| | - Cherrie Abraham
- Department of Surgery, Sir Mortimer B. Davis-Jewish General Hospital, Montreal, Quebec, Canada
| | - Stevan Dostanic
- Lady Davis Institute for Medical Research, Sir Mortimer B. Davis-Jewish General Hospital, Montreal, Quebec, Canada
| | - Melissa Meilleur
- Lady Davis Institute for Medical Research, Sir Mortimer B. Davis-Jewish General Hospital, Montreal, Quebec, Canada
| | - Tomoko Sugahara
- Lady Davis Institute for Medical Research, Sir Mortimer B. Davis-Jewish General Hospital, Montreal, Quebec, Canada
| | - Lorraine E. Chalifour
- Department of Endocrinology, Sir Mortimer B. Davis-Jewish General Hospital, Montreal, Quebec, Canada, Lady Davis Institute for Medical Research, Sir Mortimer B. Davis-Jewish General Hospital, Montreal, Quebec, Canada, Division of Experimental Medicine, Department of Medicine, McGill University, Montreal, Quebec, Canada, The Bank of Montréal Research Center for the Study of Heart Disease in Women, Sir Mortimer B. Davis-Jewish General Hospital, Montreal, Quebec, Canada
| |
Collapse
|
7
|
Flondell-Sité D, Lindblad B, Gottsäter A. High Levels of Endothelin (ET)-1 and Aneurysm Diameter Independently Predict Growth of Stable Abdominal Aortic Aneurysms. Angiology 2009; 61:324-8. [DOI: 10.1177/0003319709344190] [Citation(s) in RCA: 14] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
The etiology of abdominal aortic aneurysm (AAA) includes inflammation and endothelial dysfunction. To evaluate relations between these mechanisms and AAA growth, endothelin (ET)-1, tumor necrosis factor (TNF)-α, interleukin (IL)-6, and CD40 ligand were related to yearly AAA growth for 2.9 ± 1.6 years (mean ± SD) in 178 patients with conservatively followed AAA. Total number of follow-up years was 491. Abdominal aortic aneurysm diameter increased by 3.3 ± 4.0 mm during the first year and by 4.9 ± 4.4 mm during the first 2 years. Median (range) growth was 2.5 (—1.0 to 30.6) mm/year. When patients with AAA growth above or below median were compared, initial AAA diameter (46.1 ± 5.8 vs 42.0 ± 8.3 mm; P < .0001), age (75 ± 7 vs 72 ± 8 years; P < .029), and initial ET-1 levels (1.31 ± 0.50 vs 1.13 ± 0.49 pg/mL; P < .0177) were higher in patients with growth above median. Endothelin 1 (P = .0230) and initial AAA diameter (P = .0019) predicted AAA growth above median in logistic regression. In conclusion, higher initial levels of ET-1 and initial AAA diameter independently predict AAA growth.
Collapse
Affiliation(s)
| | - Bengt Lindblad
- University of Lund, Vascular Centre, Malmö University Hospital, Malmö, Sweden
| | - Anders Gottsäter
- University of Lund, Vascular Centre, Malmö University Hospital, Malmö, Sweden
| |
Collapse
|
8
|
Kölbel T, Donath T, Strandberg K, Flondell-Sité D, Kühme T, Gottsäter A, Lindblad B. Is Increased Thrombin Activation in Patients With Abdominal Aortic Aneurysms Dependent on Area or Volume of Aneurysm Thrombus Mass? Angiology 2009; 61:113-8. [DOI: 10.1177/0003319709335906] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
Objectives: Does thrombin activation seen in patients with abdominal aortic aneurysms (AAA) relate to the thrombus surface area or volume within the aneurysm? Patients and methods: A total of 130 patients with AAA were analyzed regarding levels of the complex between activated protein C—protein C inhibitor (APC-PCI) and AAA morphology. Analysis of APC-PCI complex was made using a sandwich immunofluorometric method. Results: Increased APC-PCI concentrations were seen in patients with AAA (0.44 μg/L; P < .001 compared with controls). The correlations of APC-PCI values were r = .13, P = .13 for aneurysm size, r = .08, P = .35 for thrombus surface area, and r = .13, P = .14 for thrombus volume. APC-PCI values elevated to 0.45 μg/L in 10 patients with AAA having no or very little thrombus mass. Conclusion: Disappointingly, no correlation was found between thrombus surface area or volume and levels of the APC-PCI complex. Mechanisms other than the AAA-sac thrombus must be evaluated as cause of thrombin activation in patients with AAA.
Collapse
Affiliation(s)
- Tilo Kölbel
- Departments of Vascular Diseases and Clinical Chemistry, University Hospital MAS, Malmö, Sweden,
| | - Tobias Donath
- Departments of Vascular Diseases and Clinical Chemistry, University Hospital MAS, Malmö, Sweden
| | - Karin Strandberg
- Departments of Vascular Diseases and Clinical Chemistry, University Hospital MAS, Malmö, Sweden
| | - Despina Flondell-Sité
- Departments of Vascular Diseases and Clinical Chemistry, University Hospital MAS, Malmö, Sweden
| | - Tobias Kühme
- Departments of Vascular Diseases and Clinical Chemistry, University Hospital MAS, Malmö, Sweden
| | - Anders Gottsäter
- Departments of Vascular Diseases and Clinical Chemistry, University Hospital MAS, Malmö, Sweden
| | - Bengt Lindblad
- Departments of Vascular Diseases and Clinical Chemistry, University Hospital MAS, Malmö, Sweden
| |
Collapse
|