Abdominal aortic aneurysm is a vascular disorder, often diagnosed incidentally, that poses substantial morbidity and mortality. Current risk assessment relies heavily on imaging and conventional risk factors. This study aimed to evaluate associations between plasma proteins and abdominal aortic aneurysm presence, progression, and mortality. A nested case-control cohort of 641 men aged 65-74 years from the Viborg Vascular screening trial (VIVA) with available plasma samples underwent proteomic profiling using mass spectrometry-based proteomics; 466 were abdominal aortic aneurysm cases, 175 were age-matched controls. Associations between individual protein levels and (1) presence of abdominal aortic aneurysm, (2) annual aneurysm growth, and (3) time-to-death were evaluated using multivariable regression models adjusted for clinical risk factors with correction for multiple testing by controlling the false discovery rate. Plasma proteins significantly associated with outcomes were further evaluated for added predictive value. Twenty-seven plasma proteins, including coagulation factor XIIIa and complement factor H, were independently associated with the presence of abdominal aortic aneurysm and significantly improved prediction beyond common risk factors (ΔAUC + 0.11, P = 0.00024). An exploratory 22-protein panel combined with diabetes status, smoking, and baseline aortic diameter improved discrimination between slow- and fast-growing aneurysms compared with aortic diameter alone (ΔAUC + 0.09, P = 0.0020). Thirteen proteins were independently associated with time-to-death and improved mortality prediction beyond clinical factors (Δc-statistics + 0.13, P = 4.07E-6). Proteomic profiling identified plasma proteins that were independently associated with abdominal aortic aneurysms presence, progression, and mortality, provided significant discrimination between slow- and fast-growing aneurysms, and improved prediction of mortality beyond established risk factors. In all supporting the potential role of plasma proteins in complementing risk stratification of abdominal aortic aneurysms.
Palstrøm et al. (Wed,) studied this question.