Abdominal aortic aneurysm (AAA) is increasing due to aging of the population and is a major cause of death among the elderly. Ultrasound screening programs are useful in early diagnosis, but aneurysm size is not always a good predictor of rupture. Our aim was to analyze the value of circulating molecules related to oxidative stress and inflammation as new biomarkers to assist the management of AAA. The markers were quantified by ELISA, and their expression in the aneurysmal wall was studied by real-time PCR and by immunostaining. Correlation analysis of the studied markers with aneurysm diameter and peak wall stress (PWS), obtained by finite element analysis, and multivariate regression analysis to assess potential confounding factors were performed. Our study shows an extensive inflammatory infiltration in the aneurysmal wall, mainly composed by T-cells, macrophages and B-cells and altered levels of reactive oxygen species (ROS), IgM, IgG, CD38, GDF15, S100A4 and CD36 in plasma and in the aneurysmal tissue of AAA patients compared with controls. Circulating levels of IgG, CD38 and GDF15 positively correlated with abdominal aortic diameter, and CD38 was correlated with PWS. Our data show that altered levels of IgG, CD38 and GDF15 have potential diagnostic value in the assessment of AAA.

Objective: To determine the prevalence and risk factors associated with peripheral arterial disease (PAD) in Northern Barcelona at 65 years of age. Methods: A single-center, cross-sectional study, including males and females 65 years of age, health care cardholders of Barcelona Nord. PAD was defined as an ankle–brachial index (ABI) < 0.9. Attending subjects were evaluated for a history of common cardiovascular risk factors. A REGICOR score was obtained, as well as a physical examination and anthropometric measurements. Results: From November 2017 to December 2018, 1174 subjects were included: 479 (40.8%) female and 695 (59.2%) male. Overall prevalence of PAD was 6.2% (95% CI: 4.8–7.6%), being 7.9% (95% CI: 5.9–9.9%) in males and 3.8% (95% CI: 2.1–5.5%) in females. An independent strong association was seen in male smokers and diabetes, with ORs pf 7.2 (95% CI: 2.8–18.6) and 1.8 (95% CI: 1.0–3.3), respectively, and in female smokers and hypertension, with ORs of 5.2 (95% CI: 1.6–17.3) and 3.3 (95% CI: 1.2–9.0). Male subjects presented with higher REGICOR scores (p < 0.001). Conclusion: Higher-risk groups are seen in male subjects with a history of smoking and diabetes and female smokers and arterial hypertension, becoming important subgroups for our primary healthcare centers and should be considered for ABI screening programs.

Article: Preoperative geriatric assessment, a promising tool to improve outcomes in aortic pathology interventions - International Angiology 2021 August;40(4):283-8 - Minerva Medica - Journals

Objective: The risk of Abdominal Aortic Aneurysm (AAA) rupture is associated with the aneurysm size and growth rate. This study aims to provide a global description of growth rates per intervals of AAA diameter size for individuals in the Spanish population, to understand possible comorbidities associated with growth rate variability, and to assess practitioners on safe follow-up visits for AAA patients. Methods: We present the Triple-A Barcelona Study (TABS), a new hospital-based longitudinal study recruiting consecutive individuals with AAAs in Barcelona. So far, 469 individuals with measurements of the abdominal aortic diameter, along with anthropometric, clinical information, and blood samples for most follow-up visits, have been recruited. Statistical modeling was performed to identify the most relevant predictors of the diameter size and expansion in individuals with AAAs using linear mixed-effect models. Results: The average growth rate per interval was 0.78 (2.34) mm/year for aneurysms with an initial diameter between 30 and 40 mm, 1.22 (3.34) mm/year for aneurysms with an initial diameter between 40 and 50 mm, and 4.12 (5.09) mm/year for aneurysms with an initial diameter equal to or greater than 50 mm. The main factors determining the growth rate beyond the aortic diameter are sex and related comorbidities (COPD and DM). The estimated time to reach the surgical threshold for individuals with small aneurysms exceeded 10 years, on average. Conclusions: Overall, this study serves as a promising step towards the development of better prediction tools to assess clinical decisions in AAA patients in the Spanish population and to guide future screening policies.