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APC-PCI complex levels for screening of AAA in patients with peripheral atherosclerosis

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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.

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Acknowledgments

This study was supported by grants from the Ernhold Lundström Foundation, Research Funds at Skåne University Hospital MAS, the Albert Påhlsson Foundation, the Hulda Ahlmroth Foundation, and from the Swedish Government under the LUA/ALF agreement.

Conflict of interest

None of the authors have any conflicts of interest to disclose.

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Authors and Affiliations

  1. Department of Vascular Diseases, Skåne University Hospital, S-205 02, Malmö, Sweden

    Moncef Zarrouk, Kave Keshavarz, Bengt Lindblad & Anders Gottsäter

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  1. Moncef Zarrouk
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  2. Kave Keshavarz
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  3. Bengt Lindblad
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  4. Anders Gottsäter
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Correspondence to Moncef Zarrouk.

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Zarrouk, M., Keshavarz, K., Lindblad, B. et al. APC-PCI complex levels for screening of AAA in patients with peripheral atherosclerosis. J Thromb Thrombolysis 36, 495–500 (2013). https://doi.org/10.1007/s11239-013-0871-6

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