ABSTRACT
OBJECTIVES: Endoleaks may be present in up to 25% of patients after endovascular abdominal aortic aneurysm repair (EVAR) and there is no clear consensus on valuable biomarkers to determine endoleak presence. The aim of this study was to examine the potential value of plasma tumor necrosis factor-α converting enzyme (TACE) and Notch1 concentrations in determining endoleak presence after EVAR. METHODS: A total of 110 patients with abdominal aortic aneurysm who underwent EVAR were enrolled in our study, and plasma TACE and Notch1 concentrations were measured prior to and 6 months after EVAR. Logistic regression was performed to assess the association of postoperative plasma TACE and Notch1 concentrations with endoleak after adjusting for potential confounders. The ability of plasma TACE and Notch1 concentrations to determine endoleak presence was assessed using receiver operating characteristic curves and area under the curve (AUC). RESULTS: Twenty-four patients developed endoleaks 6 months after EVAR. Both postoperative plasma TACE and Notch1 concentrations were higher in patients with endoleak than in those without endoleak (2376.4 ± 28.1 pg/ml vs. 2094.1 ± 27.3 pg/ml, P < 0.01; 218.6 ± 1.9 pg/ml vs. 195.0 ± 2.1 pg/ml, P < 0.01, respectively). The AUCs from receiver operating characteristic curve analysis of plasma TACE and Notch1 concentrations in determining endoleak presence were 0.844 (95% CI 0.771 to 0.918, P < 0.01) and 0.860 (95% CI 0.791 to 0.930, P < 0.01), respectively. Combining the detection of plasma Notch1 and TACE concentrations could improve the accuracy in determining endoleak presence (AUC 0.930, 95% CI 0.883 to 0.978, P < 0.01). The predicted probability cutoff of 0.22 yielded a sensitivity of 95.8% and a specificity of 82.6% for endoleak presence. CONCLUSIONS: Plasma TACE and Notch1 levels can discriminate patients with and without endoleak 6 months after EVAR, and have a potential role in screening patients requiring computed tomography angiography.
Subject(s)
ADAM17 Protein/blood , Aortic Aneurysm, Abdominal/surgery , Blood Vessel Prosthesis Implantation/adverse effects , Endoleak/blood , Endovascular Procedures/adverse effects , Receptor, Notch1/blood , Aged , Aortic Aneurysm, Abdominal/diagnostic imaging , Biomarkers/blood , Endoleak/diagnostic imaging , Endoleak/etiology , Female , Humans , Male , Predictive Value of Tests , Reproducibility of Results , Risk Assessment , Risk Factors , Time Factors , Treatment Outcome , Up-RegulationABSTRACT
OBJECTIVE: To conduct a meta-analysis for the correlation between cytochrome P450 4F2 (CYP4F2) rs2108622 (V433M) gene polymorphism and ischemic stroke. METHODS: We retrieved the case-control studies on the correlation between CYP4F2 V433M polymorphism and ischemic stroke included in domestic and international databases before January 2015 and selected the best genetic model, using RevMan 5.2 software for meta-analysis. According to the heterogeneity test results of selected literature, the effect model of consolidated data was selected, and the combined OR and 95% CI were calculated. RESULTS: A total of six documents were included. Recessive model (VM + MM vs. VV) was selected as the best genetic model. The combined results showed that: compared with wild-type VV, there are significant association between ischemic stroke and CYP4F2 polymorphism (OR merge = 1.37, 95% CI: 1.21~1.54, P < 0.001). CONCLUSION: CYP4F2 V433M may be the susceptibility gene for ischemic stroke.