Document Detail

Activated protein C-protein C inhibitor complex: a new biological marker for aortic aneurysms.
MedLine Citation:
PMID:  16678686     Owner:  NLM     Status:  MEDLINE    
OBJECTIVE: The concentration of the complex between activated protein C (APC) and protein C inhibitor (PCI) is a measure of thrombin generation. We studied whether it can provide information useful for the diagnosis and treatment of arterial vascular disease.
METHODS: Blood was obtained from 429 vascular patients admitted consecutively during September 2004 to March 2005. The APC-PCI complex was measured by using a sandwich immunofluorometric method. The patients were divided into cohorts according to the planned treatment and compared with a control group of healthy individuals.
RESULTS: The APC-PCI complex concentration varied from 0.08 to 2.50 microg/L. In the cohort of patients with aortic aneurysms (n = 78), the median APC-PCI value was 0.45 (10th to 90th percentile, 0.24-1.47), and values were clearly increased compared with all other cohorts (P < .0001). Patients with carotid disease (n = 73) yielded a median of 0.22 (10th to 90th percentile, 0.15-0.48). The median for claudicants (n = 74) was 0.26 microg/L (10th to 90th percentile, 0.15-0.75), which was higher than in those (n = 97) with critical ischemia (0.20; 10th to 90th percentile, 0.13-0.36; P < .0023). The cohort with other forms of atherosclerotic disease (n = 40) had a median of 0.23 (10th to 90th percentile, 0.14-0.42), whereas the value for a cohort of 21 patients with venous disease was 0.19 (10th to 90th percentile, 0.10-0.34). The median was 0.15 (10th to 90th percentile, 0.10-0.23) for the control group (n = 121).
CONCLUSIONS: Patients with atherosclerosis had an increased APC-PCI concentration that corresponded to increased generation of thrombin. Patients with aortic aneurysm had a threefold higher median concentration than the control group. We suggest that this remarkable increase is caused by the local activation of coagulation, and we surmise that APC-PCI measurements can be used as a screening tool to identify patients with aortic aneurysms.
Tilo Kölbel; Karin Strandberg; Ingrid Mattiasson; Johan Stenflo; Bengt Lindblad
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Publication Detail:
Type:  Journal Article; Research Support, Non-U.S. Gov't    
Journal Detail:
Title:  Journal of vascular surgery     Volume:  43     ISSN:  0741-5214     ISO Abbreviation:  J. Vasc. Surg.     Publication Date:  2006 May 
Date Detail:
Created Date:  2006-05-08     Completed Date:  2006-05-30     Revised Date:  2012-10-03    
Medline Journal Info:
Nlm Unique ID:  8407742     Medline TA:  J Vasc Surg     Country:  United States    
Other Details:
Languages:  eng     Pagination:  935-9     Citation Subset:  IM    
Department of Vascular Diseases, Malmö University Hospital, Malmö, Sweden.
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MeSH Terms
Aged, 80 and over
Aortic Aneurysm, Abdominal / blood,  diagnosis*
Atherosclerosis / blood,  diagnosis
Biological Markers / blood
Carotid Stenosis / blood,  diagnosis
Cohort Studies
Enzyme Activation
Intermittent Claudication / blood,  diagnosis
Ischemia / blood,  diagnosis
Leg / blood supply
Mass Screening
Middle Aged
Predictive Value of Tests
Protein C / metabolism*
Protein C Inhibitor / blood*
Reference Values
Statistics as Topic
Thrombin / metabolism
Reg. No./Substance:
0/Biological Markers; 0/Protein C; 0/Protein C Inhibitor; EC

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