Blood Biomarkers and Abdominal Aortic Aneurysm

Jul 16, 2015
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Authors:
Folsom AR, Yao L, Alonso A, et al.
Citation:
Circulating Biomarkers and Abdominal Aortic Aneurysm Incidence: The Atherosclerosis Risk in Communities (ARIC) Study. Circulation 2015;Jun 17:[Epub ahead of print].
Summary By:
Debabrata Mukherjee, MD, FACC

Study Questions:

What is the association of multiple circulating biomarkers with incident abdominal aortic aneurysm (AAA)?

Methods:

The ARIC (Atherosclerosis Risk in Communities) study recruited a population-based cohort of 15,792 persons between 45 and 64 years of age in 1987-1989, from Forsyth County, NC, and Jackson, MS. In the ARIC study cohort, the investigators 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. The authors performed multivariate modeling to obtain hazard ratios of incident clinical AAA in relation to biomarker quartiles by use of Cox proportional hazards regression.

Results:

Six biomarkers (white blood cell [WBC] count, fibrinogen, D-dimer, troponin T [TnT], N-terminal pro-brain natriuretic peptide [NT-proBNP], and high-sensitivity C-reactive protein [CRP]) were strongly positively associated with AAA incidence. Compared with having none of these six biomarkers in the highest quartile, the hazard ratios of AAA for those with 1, 2, 3, or 4-6 biomarkers in the highest quartile were 2.2, 3.3, 4.0, and 9.9, respectively (p trend < 0.0001), adjusted for other risk factors.

Conclusions:

The authors concluded that those higher concentrations of six biomarkers were associated with increased risk of AAA.

Perspective:

This population-based study found strong positive associations of clinical AAA incidence with circulating biomarkers of inflammation (CRP, WBC count, fibrinogen), thrombin generation (D-dimer), increased cardiac pressure and vascular stiffness (NT-proBNP), and cardiac injury (TnT). These associations were independent of other major AAA risk factors and were mostly similar for men and women and for ever-smokers and never-smokers. Multiple positive biomarkers identify a subgroup of patients at high risk of AAA and may help target a subgroup of individuals for early surveillance.

Keywords: Aortic Aneurysm, Abdominal, Biomarkers, C-Reactive Protein, Fibrinogen, Hemostasis, Inflammation, Leukocytes, Natriuretic Peptide, Brain, Risk Factors, Thrombin, Troponin T, Vascular Stiffness


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