Key result
Having 4 to 6 circulating biomarkers in the highest quartile was associated with an increased risk of incident abdominal aortic aneurysm compared with having none (HR 9.9; P for trend < 0.0001).
Why the study?
Does having multiple circulating biomarkers in the highest quartile increase the incidence of abdominal aortic aneurysm in the ARIC cohort?
Cohort
Does having multiple circulating biomarkers in the highest quartile increase the incidence of abdominal aortic aneurysm in the ARIC cohort?
Elevated levels of multiple circulating biomarkers (WBC, fibrinogen, D-dimer, troponin T, NT-proBNP, hs-CRP) are cumulatively associated with a significantly increased risk of incident abdominal aortic aneurysm.
Answers are grounded in this paper and cite their sources.
Multiple biomarkers may stratify AAA risk; extends single-marker data but leaves practice change open.
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.
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Folsom et al. (2015) conducted a cohort in Abdominal aortic aneurysm. 4 to 6 circulating biomarkers in the highest quartile vs. 0 biomarkers in the highest quartile was evaluated on Incident abdominal aortic aneurysm (HR 9.9, p=< 0.0001). Having 4 to 6 circulating biomarkers in the highest quartile was associated with an increased risk of incident abdominal aortic aneurysm compared with having none (HR 9.9; P for trend < 0.0001).
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