Aaron R Folsom1, Lu Yao2, Alvaro Alonso2, Pamela L Lutsey2, Emil Missov2, Frank A Lederle2, Christie M Ballantyne2, Weihong Tang2. 1. From Division of Epidemiology and Community Health, School of Public Health (A.R.F., L.Y., A.A., P.L.L., W.T.), Division of Cardiology, Department of Medicine, School of Medicine (E.M.), and Department of Medicine, School of Medicine (F.A.L.), University of Minnesota, Minneapolis; Minneapolis VA Health Care System, MN (F.A.L.); and Section of Cardiovascular Research, Department of Medicine, Baylor College of Medicine and Center for Cardiovascular Disease Prevention, Houston Methodist DeBakey Heart and Vascular Center, TX (C.M.B.). folso001@umn.edu. 2. From Division of Epidemiology and Community Health, School of Public Health (A.R.F., L.Y., A.A., P.L.L., W.T.), Division of Cardiology, Department of Medicine, School of Medicine (E.M.), and Department of Medicine, School of Medicine (F.A.L.), University of Minnesota, Minneapolis; Minneapolis VA Health Care System, MN (F.A.L.); and Section of Cardiovascular Research, Department of Medicine, Baylor College of Medicine and Center for Cardiovascular Disease Prevention, Houston Methodist DeBakey Heart and Vascular Center, TX (C.M.B.).
Abstract
BACKGROUND: The pathogenesis of abdominal aortic aneurysm (AAA) is complex. Cross-sectional studies have connected circulating biomarkers with AAA, but prospective evidence is limited. METHODS AND RESULTS: In the Atherosclerosis Risk in Communities Study cohort, we measured multiple blood biomarkers of inflammation, hemostasis, thrombin generation, cardiac dysfunction, and vascular stiffness and identified incident AAAs during follow-up using hospital discharge codes. Six biomarkers (white blood cell count, fibrinogen, D-dimer, troponin T, N-terminal pro-brain natriuretic peptide, and high-sensitivity C-reactive protein) were strongly associated positively with AAA incidence. Compared with having none of these 6 biomarkers in the highest quartile, the hazard ratios of AAA for those with 1, 2, 3, or 4 to 6 biomarkers in the highest quartile were 2.2, 3.3, 4.0, and 9.9, respectively (P for trend < 0.0001) after adjustment for other risk factors. CONCLUSIONS: This prospective study found that higher concentrations of 6 biomarkers were associated with increased risk of AAA. The more markers that fell into the highest quartile, the higher the AAA risk was. Multiple positive biomarkers identify a subgroup of patients at high risk of AAA.
BACKGROUND: The pathogenesis of abdominal aortic aneurysm (AAA) is complex. Cross-sectional studies have connected circulating biomarkers with AAA, but prospective evidence is limited. METHODS AND RESULTS: In the Atherosclerosis Risk in Communities Study cohort, we measured multiple blood biomarkers of inflammation, hemostasis, thrombin generation, cardiac dysfunction, and vascular stiffness and identified incident AAAs during follow-up using hospital discharge codes. Six biomarkers (white blood cell count, fibrinogen, D-dimer, troponin T, N-terminal pro-brain natriuretic peptide, and high-sensitivity C-reactive protein) were strongly associated positively with AAA incidence. Compared with having none of these 6 biomarkers in the highest quartile, the hazard ratios of AAA for those with 1, 2, 3, or 4 to 6 biomarkers in the highest quartile were 2.2, 3.3, 4.0, and 9.9, respectively (P for trend < 0.0001) after adjustment for other risk factors. CONCLUSIONS: This prospective study found that higher concentrations of 6 biomarkers were associated with increased risk of AAA. The more markers that fell into the highest quartile, the higher the AAA risk was. Multiple positive biomarkers identify a subgroup of patients at high risk of AAA.
Authors: Liat S Gutin; Vladimir K Bakalov; Douglas R Rosing; Andrew E Arai; Ahmed M Gharib; Carolyn A Bondy Journal: Am Heart J Date: 2012-09 Impact factor: 4.749
Authors: Carlos Iribarren; Jeanne A Darbinian; Alan S Go; Bruce H Fireman; Chong D Lee; Douglas P Grey Journal: Ann Epidemiol Date: 2007-05-18 Impact factor: 3.797
Authors: Albert W Tsai; Mary Cushman; Wayne D Rosamond; Susan R Heckbert; Russell P Tracy; Nena Aleksic; Aaron R Folsom Journal: Am J Med Date: 2002-12-01 Impact factor: 4.965
Authors: Aaron R Folsom; Nena Aleksic; Lu Wang; Mary Cushman; Kenneth K Wu; Richard H White Journal: Arterioscler Thromb Vasc Biol Date: 2002-06-01 Impact factor: 8.311
Authors: Lu Yao; Aaron R Folsom; Alvaro Alonso; Pamela L Lutsey; James S Pankow; Weihua Guan; Susan Cheng; Frank A Lederle; Weihong Tang Journal: Atherosclerosis Date: 2018-02-04 Impact factor: 5.162
Authors: Yasuhiko Kubota; Aaron R Folsom; James S Pankow; Lynne E Wagenknecht; Weihong Tang Journal: Ann Epidemiol Date: 2017-12-16 Impact factor: 3.797
Authors: Weihong Tang; Lu Yao; Ron C Hoogeveen; Alvaro Alonso; David J Couper; Pamela L Lutsey; Carol C Steenson; Weihua Guan; David W Hunter; Frank A Lederle; Aaron R Folsom Journal: Angiology Date: 2018-06-26 Impact factor: 3.619
Authors: Aaron R Folsom; Pamela L Lutsey; Ronald Klein; Barbara E Klein; Weihong Tang Journal: Ophthalmic Epidemiol Date: 2017-12-27 Impact factor: 1.648
Authors: Caitlin W Hicks; Dan Wang; Natalie R Daya; B Gwen Windham; Christie M Ballantyne; Kunihiro Matsushita; Elizabeth Selvin Journal: Clin Chem Date: 2020-05-01 Impact factor: 8.327