title: Circulating Biomarkers and Abdominal Aortic Aneurysm Incidence: The Atherosclerosis Risk in Communities (ARIC) Study.
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.
  
  
  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.affiliation: 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.
authors.forename: Aaron R
authors.initials: AR
authors.lastname: Folsom
authors.affiliation: 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.).
authors.forename: Lu
authors.initials: L
authors.lastname: Yao
authors.affiliation: 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.).
authors.forename: Alvaro
authors.initials: A
authors.lastname: Alonso
authors.affiliation: 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.).
authors.forename: Pamela L
authors.initials: PL
authors.lastname: Lutsey
authors.affiliation: 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.).
authors.forename: Emil
authors.initials: E
authors.lastname: Missov
authors.affiliation: 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.).
authors.forename: Frank A
authors.initials: FA
authors.lastname: Lederle
authors.affiliation: 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.).
authors.forename: Christie M
authors.initials: CM
authors.lastname: Ballantyne
authors.affiliation: 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.).
authors.forename: Weihong
authors.initials: W
authors.lastname: Tang
mesh_terms: D017544:Aortic Aneurysm, Abdominal / Q000097:blood / Q000000981:diagnostic imaging / Q000453:epidemiology*; D050197:Atherosclerosis / Q000453:epidemiology; D015415:Biomarkers / Q000097:blood; D001798:Blood Proteins / Q000032:analysis; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D015994:Incidence; D007249:Inflammation / Q000097:blood; D008297:Male; D008875:Middle Aged; D020097:Natriuretic Peptide, Brain / Q000097:blood; D010351:Patient Discharge / Q000706:statistics & numerical data; D010446:Peptide Fragments / Q000097:blood; D016016:Proportional Hazards Models; D011446:Prospective Studies; D012306:Risk; D014463:Ultrasonography; D014481:United States / Q000453:epidemiology
chemical_list: D015415:Biomarkers; D001798:Blood Proteins; D010446:Peptide Fragments; C109794:pro-brain natriuretic peptide (1-76); D020097:Natriuretic Peptide, Brain
keywords: aortic aneurysm, abdominal; cohort studies; risk factors