Diagnostic value of ADAMTS-9 in acute aortic dissection_Chinese Journal of Clinical Thoracic and Cardiovascular Surgery

Authors：

FAN Kangjun ¹ , HE Qian ² , GU Jun ¹ , ZHANG Hongwei ¹ , LIANG Huaimin ¹ , YANG Peng ¹ , ZHANG Eryong ¹ ,  HU Jia ¹

1. Department of Cardiovascular Surgery, West China Hospital, Sichuan University, Chengdu, 610041, P.R.China;
2. Emergency Department,West China Hospital, Sichuan University, Chengdu, 610041, P.R.China;

Corresponding author：

HU Jia, Email: humanjia@msn.com

Keywords：

Acute aortic dissection; ADAMTS-9; receiver operating characteristic curve; biomarker

DOI：

10.7507/1007-4848.201612028

Video：

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Objective To explore the diagnostic value of a disintegrin-like and metalloproteinase with thrombospondin type 1 motifs (ADAMTS)-9 in acute aortic dissection (AAD). Methods A total of 328 patients with acute onset of chest pain within 24 hours were enrolled in West China Hospital from January 2015 to June 2016 and according to the results of computed tomography angiography they were divided into an AAD group (n=172, 107 males, 65 females, mean age of 50.4±13.1 years) and a control group (n=156, 89 males, 67 females, mean age of 54.9±14.7 years). The enzyme-linked immunosorbent assay (ELISA) test was used to measure the level of ADAMTS-9. Results Patients in two groups had no significant difference in age, gender, smoke history, hypertension history, total cholesterol, triacylglyceride and hemoglobin (P>0.05). But systolic and diastolic blood pressures were significantly higher in the AAD group than those in the control group (P<0.05, respectively). The level of ADAMTS-9 was significantly higher in the AAD group than that in the control group (249.4±186.8 ng/mlvs. 78.2±48.6 ng/ml,t=11.107, P<0.001). Receiver operating characteristic curve analysis showed that ADAMTS-9 (156.7 ng/ml) was predictive in the diagnosis of AAD with sensitivity of 0.942 and specificity of 0.628. Conclusion ADAMTS-9 might be an effective and important biomarker in diagnosis of AAD.

Citation： FAN Kangjun, HE Qian, GU Jun, ZHANG Hongwei, LIANG Huaimin, YANG Peng, ZHANG Eryong, HU Jia. Diagnostic value of ADAMTS-9 in acute aortic dissection. Chinese Journal of Clinical Thoracic and Cardiovascular Surgery, 2017, 24(5): 355-358. doi: 10.7507/1007-4848.201612028 Copy

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2.	Pare JR, Liu R, Moore CL, et al. Emergency physician focused cardiac ultrasound improves diagnosis of ascending aortic dissection. Am J Emerg Med, 2016, 34(3): 486-492.
3.	Rodríguez-Manzaneque JC, Fernández-Rodríguez R, Rodríguez-Baena FJ. ADAMTS proteases in vascular biology. Matrix Biol, 2015, 44-46: 38-45.
4.	吴文静, 林多茂, 王慧, 等. 主动脉夹层和急性冠脉综合征患者血浆 ADAMTS-9 水平比较研究. 中日友好医院学报, 2010, 24(5): 259-261.
5.	Erbel R, Aboyans V, Boileau C, et al. 2014 ESC Guidelines on the diagnosis and treatment of aortic diseases: Document covering acute and chronic aortic diseases of the thoracic and abdominal aorta of the adult. The Task Force for the Diagnosis and Treatment of Aortic Diseases of the European Society of Cardiology (ESC). Eur Heart J, 2014, 35 (41): 2873-2926.
6.	Xia L, Li JH, Zhao K, et al. Incidence and in-hospital mortality of acute aortic dissection in China: analysis of China Health Insurance Research (CHIRA) Data 2011. J Geriatr Cardiol, 2015, 12(5): 502-506.
7.	Pape LA, Awais M, Woznicki EM, et al. Presentation, diagnosis, and outcomes of acute aortic dissection: 17-year trends from the international registry of acute aortic dissection. J Am Coll Cardiol. 2015, 66(4): 350-358.
8.	Listijono DR, Pepper JR. Current imaging techniques and potential biomarkers in the diagnosis of acute aortic dissection. JRSM Short Rep, 2012, 3(11): 76.
9.	Dancevic CM, McCulloch DR, Ward AC. The ADAMTS hyalectanase family: biological insights from diverse species. Biochem J, 2016, 473(14): 2011-2022.
10.	Kelwick R, Desanlis I, Wheeler GN, et al. The ADAMTS (A Disintegrin and Metalloproteinase with Thrombospondin motifs) family. Genome Biol, 2015, 16: 113.
11.	Nienaber CA, Eagle KA. Aortic dissection: new frontiers in diagnosis and management: Part II: therapeutic management and follow-up. Circulation, 2003, 108(6): 772-778.
12.	Nienaber CA, Eagle KA. Aortic dissection: new frontiers in diagnosis and management: Part I: from etiology to diagnostic strategies. Circulation, 2003, 108(5): 628-635.
13.	Theocharis AD, Tsolakis I, Hjerpe A, et al. Human abdominal aortic aneurysm is characterized by decreased versican concentration and specific downregulation of versican isoform V(0). Atherosclerosis, 2001, 154(2): 367-376.
14.	Peng W, Peng Z, Chai X, et al. Potential biomarkers for early diagnosis of acute aortic dissection. Heart Lung, 2015, 44(3): 205-208.
15.	Katoh H, Suzuki T, Yokomori K, et al. A novel immunoassay of smooth muscle myosin heavy chain in serum. J Immunol Methods, 1995, 185(1): 57-63.
16.	Suzuki T, Katoh H, Tsuchio Y, et al. Diagnostic implications of elevated levels of smooth-muscle myosin heavy-chain protein in acute aortic dissection. The smooth muscle myosin heavy chain study. Ann Intern Med, 2000, 133(7): 537-541.
17.	Asha SE, Miers JW. A systematic review and meta-analysis of D-dimer as a rule-out test for suspected acute aortic dissection. Ann Emerg Med, 2015, 66(4): 368-378.
18.	Watanabe H, Horita N, Shibata Y, et al. Diagnostic test accuracy of D-dimer for acute aortic syndrome: systematic review and metaanalysis of 22 studies with 5000 subjects. Sci Rep. 2016, 6: 26893.
19.	生伟, 池一凡, 牛兆倬, 等. 急性 Stanford A 型主动脉夹层术后 ICU 监护时间延长的危险因素析. 中国胸心血管外科临床杂志, 2016, 23(5): 434-439.
20.	Eggebrecht H, Naber CK, Bruch C, et al. Value of plasma fibrin D-dimers for detection of acute aortic dissection. J Am Coll Cardiol, 2004, 44(4): 804-809.

1. Hagan PG, Nienaber CA, Isselbacher EM, et al. The International Registry of Acute Aortic Dissection (IRAD): new insights into an old disease. JAMA, 2000, 283(7): 897-903.
2. Pare JR, Liu R, Moore CL, et al. Emergency physician focused cardiac ultrasound improves diagnosis of ascending aortic dissection. Am J Emerg Med, 2016, 34(3): 486-492.
3. Rodríguez-Manzaneque JC, Fernández-Rodríguez R, Rodríguez-Baena FJ. ADAMTS proteases in vascular biology. Matrix Biol, 2015, 44-46: 38-45.
4. 吴文静, 林多茂, 王慧, 等. 主动脉夹层和急性冠脉综合征患者血浆 ADAMTS-9 水平比较研究. 中日友好医院学报, 2010, 24(5): 259-261.
5. Erbel R, Aboyans V, Boileau C, et al. 2014 ESC Guidelines on the diagnosis and treatment of aortic diseases: Document covering acute and chronic aortic diseases of the thoracic and abdominal aorta of the adult. The Task Force for the Diagnosis and Treatment of Aortic Diseases of the European Society of Cardiology (ESC). Eur Heart J, 2014, 35 (41): 2873-2926.
6. Xia L, Li JH, Zhao K, et al. Incidence and in-hospital mortality of acute aortic dissection in China: analysis of China Health Insurance Research (CHIRA) Data 2011. J Geriatr Cardiol, 2015, 12(5): 502-506.
7. Pape LA, Awais M, Woznicki EM, et al. Presentation, diagnosis, and outcomes of acute aortic dissection: 17-year trends from the international registry of acute aortic dissection. J Am Coll Cardiol. 2015, 66(4): 350-358.
8. Listijono DR, Pepper JR. Current imaging techniques and potential biomarkers in the diagnosis of acute aortic dissection. JRSM Short Rep, 2012, 3(11): 76.
9. Dancevic CM, McCulloch DR, Ward AC. The ADAMTS hyalectanase family: biological insights from diverse species. Biochem J, 2016, 473(14): 2011-2022.
10. Kelwick R, Desanlis I, Wheeler GN, et al. The ADAMTS (A Disintegrin and Metalloproteinase with Thrombospondin motifs) family. Genome Biol, 2015, 16: 113.
11. Nienaber CA, Eagle KA. Aortic dissection: new frontiers in diagnosis and management: Part II: therapeutic management and follow-up. Circulation, 2003, 108(6): 772-778.
12. Nienaber CA, Eagle KA. Aortic dissection: new frontiers in diagnosis and management: Part I: from etiology to diagnostic strategies. Circulation, 2003, 108(5): 628-635.
13. Theocharis AD, Tsolakis I, Hjerpe A, et al. Human abdominal aortic aneurysm is characterized by decreased versican concentration and specific downregulation of versican isoform V(0). Atherosclerosis, 2001, 154(2): 367-376.
14. Peng W, Peng Z, Chai X, et al. Potential biomarkers for early diagnosis of acute aortic dissection. Heart Lung, 2015, 44(3): 205-208.
15. Katoh H, Suzuki T, Yokomori K, et al. A novel immunoassay of smooth muscle myosin heavy chain in serum. J Immunol Methods, 1995, 185(1): 57-63.
16. Suzuki T, Katoh H, Tsuchio Y, et al. Diagnostic implications of elevated levels of smooth-muscle myosin heavy-chain protein in acute aortic dissection. The smooth muscle myosin heavy chain study. Ann Intern Med, 2000, 133(7): 537-541.
17. Asha SE, Miers JW. A systematic review and meta-analysis of D-dimer as a rule-out test for suspected acute aortic dissection. Ann Emerg Med, 2015, 66(4): 368-378.
18. Watanabe H, Horita N, Shibata Y, et al. Diagnostic test accuracy of D-dimer for acute aortic syndrome: systematic review and metaanalysis of 22 studies with 5000 subjects. Sci Rep. 2016, 6: 26893.
19. 生伟, 池一凡, 牛兆倬, 等. 急性 Stanford A 型主动脉夹层术后 ICU 监护时间延长的危险因素析. 中国胸心血管外科临床杂志, 2016, 23(5): 434-439.
20. Eggebrecht H, Naber CK, Bruch C, et al. Value of plasma fibrin D-dimers for detection of acute aortic dissection. J Am Coll Cardiol, 2004, 44(4): 804-809.

Chinese Journal of Clinical Thoracic and Cardiovascular Surgery

Diagnostic value of ADAMTS-9 in acute aortic dissection

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