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(Circulation. 2008;118:2382-2392.)
© 2008 American Heart Association, Inc.

Aortic Diseases

Circulating Markers of Abdominal Aortic Aneurysm Presence and Progression

Jonathan Golledge, MChir, FRACS, FRCS; Philip S. Tsao, PhD; Ronald L. Dalman, MD; Paul E. Norman, DS, FRACS

From the Vascular Biology Unit, School of Medicine and Dentistry, James Cook University, Townsville, Queensland, Australia (J.G.); Divisions of Vascular Surgery (R.L.D.) and Cardiovascular Medicine (P.S.T.), Stanford University, San Francisco, Calif; and School of Surgery, University of Western Australia, Fremantle Hospital, Fremantle, WA Australia (P.E.N.).

Correspondence to Professor Jonathan Golledge, Director, Vascular Biology Unit, Department of Surgery, School of Medicine, James Cook University, Townsville, Queensland, Australia 4811. E-mail jonathan.golledge@jcu.edu.au

Key Words: aneurysm • biomarkers • plasma • serum

An extract of the first 250 words of the full text is provided, because this article has no abstract.

	Introduction

 
Over the last decade, abdominal aortic aneurysm (AAA) has increasingly been recognized as an important cause of mortality in older persons. In 1999, for example, AAA was noted to be the 15th leading cause of mortality in the United States.¹ Exact estimates of AAA-related fatalities are hampered by the low rate of postmortems when sudden death occurs in elderly subjects; however, recent figures suggest that AAA accounts for 15 000 deaths annually in the United States despite the increasing number of elective AAA repairs.^2,3 Approximately 25 000 endovascular and open AAA repairs are performed annually in the United States.³

Ultrasound screening of men >65 years of age has been demonstrated to reduce AAA-related mortality, and selective screening (of men 65 of age who have ever smoked) has been introduced in the United States.⁴ Most screen-detected AAAs are small (<55 mm), and surgery for these AAAs has not been demonstrated to improve outcome.^5–7 In a screening study of 12 203 men 65 years of age performed in Australia, for example, 814 (6.7%) had a small AAA measuring 30 to 54 mm, but only 61 (0.5%) had a large AAA (55 mm).⁸ The increase in identification of small AAAs resulting from screening programs, in association with an ageing population, highlights the number of deficiencies in the current diagnosis and management of this condition.

First, there are no accurate nonimaging methods of diagnosing small AAAs, with clinical examination being inaccurate.⁹ Second, prognostic determinants for AAA are relatively poorly defined.¹⁰ Approximately 70% of . . . [Full Text of this Article]

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