Molecular biomarkers associated with progression and adverse outcomes in human ascending thoracic aortic aneurysm: a systematic review protocol
Tommaso D’Anna, Beatrice Belmonte, Alessandro Mangogna, Augusto Orlandi, Carmela Rita BalistreriObjective:
This systematic review will identify, classify, and synthesize evidence on molecular biomarkers (circulating, tissue, genetic, epigenetic, proteomic, metabolomic, and inflammatory) associated with the progression and outcomes of ascending thoracic aortic aneurysm (ATAA) in human populations.
Introduction:
ATAA is a heterogeneous condition driven by genetic, epigenetic, inflammatory, proteolytic, and metabolic alterations that are not completely understood. Current management relies mainly on aortic diameter and does not incorporate molecular data. Emerging evidence suggests that circulating, tissue, genetic, epigenetic, metabolic, and proteomic biomarkers may support diagnosis, improve prognostic assessment, identify high-risk patients, and clarify mechanisms of medial degeneration. Existing studies are fragmented and inconsistent, and are based on small observational cohorts, highlighting the need for a rigorous synthesis.
Eligibility criteria:
This review will include observational studies that quantify molecular biomarkers in blood or biopsy samples from adult populations with ATAA.
Methods:
We will search PubMed, Embase, the Cochrane Library, Scopus, Web of Science, trial registries, dissertations and theses databases, preprint repositories, and other gray literature sources for eligible evidence from 2015 to the present. Study selection, critical appraisal, and data extraction will follow the JBI methodology. A narrative synthesis will summarize the findings. Where sufficient clinical and methodological homogeneity exists, meta-analysis will be conducted using random-effects models. The certainty of evidence will be assessed using the Grading of Recommendations Assessment, Development and Evaluation (GRADE) approach adapted for prognostic and etiological research.
Review registration:
PROSPERO CRD420251237933