Biomarkers and degree of atherosclerosis are independently associated with incident atherosclerotic cardiovascular disease in a primary prevention cohort: The ARIC study.
Biomarkers and atherosclerosis imaging have been studied individually for association with incident cardiovascular disease (CVD); however, limited data exist on whether the biomarkers are associated with events with a similar magnitude in the presence of atherosclerosis. In this study, we assessed whether the presence of atherosclerosis as measured by carotid intima media thickness (cIMT) affects the association between biomarkers known to be associated with coronary heart disease (CHD) and incident cardiovascular disease (CVD) in a primary prevention cohort.



8127 participants from the ARIC study (4th visit, 1996-1998) were stratified as having minimal, mild, or substantial atherosclerosis by cIMT. Levels of C-reactive protein, lipoprotein-associated phospholipase A2, cardiac troponin T, N-terminal pro-brain natriuretic peptide, lipoprotein(a), cystatin C, and urine albumin to creatinine ratio were measured in each participant. Hazard ratios were used to determine the relationship between the biomarkers and incident CHD, stroke, and CVD in each category of atherosclerosis.



While each of the biomarkers was significantly associated with risk of events overall, we found no significant differences noted in the strength of association of biomarkers with CHD, stroke, and CVD when analyzed by degree of atherosclerosis.



These findings suggest that the level of atherosclerosis does not significantly influence the association between biomarkers and CVD.
Baylor College of Medicine, United States.
Anandita
A
Agarwala
Michael E DeBakey Veterans Affairs Hospital, United States; Methodist DeBakey Heart and Vascular Center, United States.
Salim
S
Virani
University of North Carolina at Chapel Hill School of Global Public Health, United States.
David
D
Couper
University of North Carolina at Chapel Hill School of Global Public Health, United States.
Lloyd
L
Chambless
University of Texas, School of Public Health, Houston, United States.
Eric
E
Boerwinkle
University of Wisconsin School of Medicine and Public Health, United States.
Brad C
BC
Astor
Baylor College of Medicine, United States.
Ron C
RC
Hoogeveen
Johns Hopkins School of Public Health, United States.
Joe
J
Coresh
Johns Hopkins School of Public Health, United States.
A Richey
AR
Sharrett
University of Minnesota, Division of Epidemiology and Community Health, Minneapolis, MN, United States.
Aaron R
AR
Folsom
University of Mississippi, United States.
Tom
T
Mosley
Baylor College of Medicine, United States; Methodist DeBakey Heart and Vascular Center, United States.
Christie M
CM
Ballantyne
Michael E DeBakey Veterans Affairs Hospital, United States; Baylor College of Medicine, United States; Methodist DeBakey Heart and Vascular Center, United States. Electronic address: vnambi@bcm.edu.
Vijay
V
Nambi
D043203:1-Alkyl-2-acetylglycerophosphocholine Esterase / Q000097:blood; D000419:Albuminuria / Q000097:blood; D050197:Atherosclerosis / Q000097:blood* / Q000150:complications; D015415:Biomarkers / Q000097:blood* / Q000378:metabolism; D002097:C-Reactive Protein / Q000032:analysis; D002318:Cardiovascular Diseases / Q000097:blood* / Q000150:complications; D059168:Carotid Intima-Media Thickness; D015331:Cohort Studies; D055316:Cystatin C / Q000097:blood; D005260:Female; D006801:Humans; D015994:Incidence; D017270:Lipoprotein(a) / Q000097:blood; D008297:Male; D008875:Middle Aged; D020097:Natriuretic Peptide, Brain / Q000097:blood; D010446:Peptide Fragments / Q000097:blood; D011322:Primary Prevention / Q000379:methods; D011446:Prospective Studies; D012907:Smoking; D020107:Troponin T / Q000097:blood; D014481:United States
D015415:Biomarkers; D055316:Cystatin C; D017270:Lipoprotein(a); D010446:Peptide Fragments; D020107:Troponin T; C109794:pro-brain natriuretic peptide (1-76); D020097:Natriuretic Peptide, Brain; D002097:C-Reactive Protein; D043203:1-Alkyl-2-acetylglycerophosphocholine Esterase
Cardiovascular disease; Carotid intima media thickness; Coronary heart disease; High sensitivity C- reactive protein; High sensitivity troponin T; Lipoprotein associated phospholipase A2; NT-pro B-type natriuretic peptide; Stroke; lipoprotein(a)
Int J Cardiol. 2013 Oct 15;168(6):5126-34
23978367
JAMA. 2001 Jul 25;286(4):421-6
11466120
Adv Clin Exp Med. 2014 Jul-Aug;23(4):551-8
25166439
Expert Rev Mol Diagn. 2002 Jan;2(1):17-22
11963798
Am J Epidemiol. 2000 Mar 1;151(5):478-87
10707916
Diabetes Care. 2003 Oct;26(10):2777-84
14514579
Atherosclerosis. 2005 Jun;180(2):381-8
15910866
Clin J Am Soc Nephrol. 2013 Mar;8(3):434-42
23258794
Stroke. 1994 Dec;25(12 ):2377-83
7974576
N Engl J Med. 2000 Oct 19;343 (16):1148-55
11036120
Circulation. 2011 Apr 5;123(13):1367-76
21422391
N Engl J Med. 1999 Jan 7;340(1):14-22
9878640
Am J Epidemiol. 1997 Sep 15;146(6):483-94
9290509
Am J Epidemiol. 1989 Apr;129(4):687-702
2646917
N Engl J Med. 2011 Jul 21;365(3):213-21
21774709
Am J Kidney Dis. 2012 May;59(5):653-62
22305758
Circulation. 1986 Dec;74(6):1399-406
3536154
Dis Markers. 2013;35(5):551-9
24249942
Circulation. 2008 Jan 15;117(2):176-84
18086931
J Neuroimaging. 1991 May;1(2):68-73
10149803
Circulation. 2004 Feb 24;109 (7):837-42
14757686
Circulation. 2004 Oct 5;110(14 ):1903-8
15451783
Circulation. 2007 Jul 3;116(1):32-8
17576871
Arch Intern Med. 2008 Jun 23;168(12 ):1333-9
18574091
J Am Coll Cardiol. 2014 Jul 1;63(25 Pt B):2889-934
24239923
J Am Heart Assoc. 2013 Apr 08;2(2):e000087
23568342
Clin Chem. 2009 Feb;55(2):219-28
19095730
N Engl J Med. 2006 Dec 21;355(25):2631-9
17182988
J Am Coll Cardiol. 2010 Apr 13;55(15):1600-7
20378078
Circulation. 2012 Jan 17;125(2):241-9
22128224
Nat Clin Pract Cardiovasc Med. 2008 Oct;5(10):621-35
18711404
J Lipid Res. 2011 Jun;52(6):1181-7
21478162
Thromb Haemost. 2009 Oct;102(4):615-9
19806245
Arterioscler Thromb Vasc Biol. 2011 Jun;31(6):1430-8
21474823
JAMA. 2009 Jul 22;302(4):412-23
19622820
Eur Heart J. 2012 Jan;33(2):183-90
21666250
Circulation. 1997 Sep 2;96(5):1432-7
9315528
J Intern Med. 2014 Aug;276(2):184-94
25184160
Atherosclerosis. 2012 May;222(1):135-7
22349088
Clin Biochem. 2014 Nov;47(16-17):176-81
25084128
Ultrasound Med Biol. 1996;22(7):791-9
8923698
Metab Syndr Relat Disord. 2014 Nov;12(9):472-6
25118891
J Clin Epidemiol. 2003 Sep;56(9):880-90
14505774
J Am Coll Cardiol. 2015 Oct 13;66(15):1643-53
26449133
JAMA. 2005 Apr 6;293(13):1609-16
15811980
Cerebrovasc Dis. 2012;34(4):290-6
23128470
Ultrasound Med Biol. 2001 Mar;27(3):357-65
11369121
J Am Coll Cardiol. 2016 Jan 19;67(2):139-47
26791059
J Am Soc Echocardiogr. 2008 Feb;21(2):93-111; quiz 189-90
18261694
Am J Epidemiol. 2004 Aug 1;160(3):259-69
15257999
Clin Chem. 2011 Jun;57(6):891-7
21519038
Int J Cardiol. 2014 Sep 20;176(2):444-9
25127973
Ultrasound Med Biol. 1996;22(5):545-54
8865551
J Clin Epidemiol. 1996 Feb;49(2):223-33
8606324
Am J Cardiol. 2016 Apr 1;117(7):1185-91
26869392