Incidence of fatal or repaired abdominal aortic aneurysm in relation to inflammation-sensitive plasma proteins.
Background- Inflammation is an important pathophysiological feature of abdominal aortic aneurysms (AAA). Whether elevated levels of inflammation-sensitive plasma proteins (ISPs) predict the long-term risk of fatal or repaired AAA is largely unknown.


RESULTS
Five ISPs (fibrinogen, orosomucoid, alpha1-antitrypsin, haptoglobin, and ceruloplasmin) were measured in 6075 healthy men, mean age 46.8+/-3.7 years. After a mean time of 19 years, 63 men had a fatal or surgically/endovascularly repaired AAA. Risk of treatment or death from future AAA was studied in relation to the ISPs. The risk of future AAA increased significantly with the number of elevated ISPs (ie, in the top quartile). The proportions with future AAA were 0.4%, 1.0%, 1.3%, and 2.3% for men with none, one, two, and > or =3 ISPs, respectively, in the top quartile (trend: P<0.0001). The corresponding odds ratios were 1.00 (reference), 1.9 (95% CI: 0.8 to 4.5), 2.2 (0.9 to 5.5), and 3.2 (1.4 to 7.2), respectively, adjusted for age, screening year, smoking, cholesterol, triglycerides, systolic blood pressure and physical inactivity (trend: P=0.004).


CONCLUSIONS
The incidence of fatal or repaired AAA is associated with the ISP levels. In this population-based study, elevated ISPs could be observed many years before the clinical manifestation of disease.
Engström
Gunnar
G
Department of Community Medicine, Lund University, Malmö University Hospital, Sweden. Gunnar.Engstrom@smi.mas.lu.se
Börner
Gabriel
G
Lindblad
Bengt
B
Janzon
Lars
L
Lindgärde
Folke
F
D000209:Acute-Phase Proteins / Q000378:metabolism*; D000328:Adult; D017544:Aortic Aneurysm, Abdominal / Q000097:blood* / Q000453:epidemiology* / Q000401:mortality / Q000601:surgery; D015331:Cohort Studies; D006801:Humans; D015994:Incidence; D007249:Inflammation / Q000097:blood; D008297:Male; D008403:Mass Screening / Q000379:methods / Q000706:statistics & numerical data; D008875:Middle Aged; D015999:Multivariate Analysis; D016017:Odds Ratio; D011159:Population Surveillance / Q000379:methods; D011237:Predictive Value of Tests; D012307:Risk Factors; D013995:Time
D000209:Acute-Phase Proteins