Key result
Plasma aggrecan levels accurately detected acute type A aortic dissection with an area under the curve of 0.947, yielding 97% sensitivity and 81% specificity at a 14.3 ng/mL threshold.
Why the study?
Acute type A aortic dissection is a life-threatening pathology with high hourly mortality without surgery, making early diagnosis crucial for timely treatment.
Does Aggrecan (ACAN) plasma concentration accurately diagnose acute type A aortic dissection compared to other cardiac conditions and healthy controls?
Case-Control (n=96)
No
Does Aggrecan (ACAN) plasma concentration accurately diagnose acute type A aortic dissection compared to other cardiac conditions and healthy controls?
Effect estimate: AUC 0.947
Aggrecan (ACAN) is a highly sensitive and specific novel plasma biomarker for the early detection of acute type A aortic dissection, effectively distinguishing it from myocardial infarction and healthy controls.
Supports further investigation of aggrecan for acute type A aortic dissection diagnosis; does not yet justify routine clinical use.
Acute type A aortic dissection (ATAAD) constitutes a life-threatening aortic pathology with significant morbidity and mortality. Without surgical intervention the usual mortality rate averages between 1-2 % per hour. Thus, an early diagnosis of ATAAD is of pivotal importance to direct the affected patients to the appropriate treatment. As a consequence, we investigated whether aggrecan (ACAN) is a potential biomarker for diagnosing ATAAD. Our investigation showed that ACAN mRNA expression is highest in aortic tissue from ATAAD patients. Mean ACAN protein concentration showed a significantly higher plasma concentration in ATAAD patients (38.59 ng/mL) compared to plasma of patients with thoracic aortic aneurysms (4.45 ng/mL), patients with ST-elevation myocardial infarction (11.77 ng/mL) and healthy volunteers (8.05 ng/mL). Cardiac enzymes like creatine kinase MB and cardiac troponin T showed no correlation with ACAN levels in ATAAD patients. Receiver-operator characteristics (ROC) curve analysis for ATAAD patients versus control subjects revealed an area under the curve of 0.947 and an optimum discrimination limit of ACAN plasma levels at 14.3 ng/mL with a corresponding sensitivity of 97 % and specificity of 81 %. According to our findings ACAN is a reliable potential biomarker in plasma samples to detect ATAAD with high sensitivity and specificity.
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König et al. (2021) conducted a case-control in Acute type A aortic dissection (n=96). Aggrecan (ACAN) plasma levels vs. Healthy volunteers and patients with other cardiovascular diseases was evaluated on Diagnostic accuracy for acute type A aortic dissection (Area under the ROC curve) (AUC 0.947). Plasma aggrecan levels accurately detected acute type A aortic dissection with an area under the curve of 0.947, yielding 97% sensitivity and 81% specificity at a 14.3 ng/mL threshold.
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