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Lp-PLA2 activity and mass for prediction of incident abdominal aortic aneurysms : A prospective longitudinal cohort study

Acosta, Stefan LU ; Taimour, Soumia LU ; Gottsäter, Anders LU ; Persson, Margaretha LU ; Engström, Gunnar LU ; Melander, Olle LU ; Zarrouk, Moncef LU ; Nilsson, Peter M. LU and Smith, J. Gustav LU (2017) In Atherosclerosis 262. p.14-18
Abstract

Background and aims The pathogenesis of abdominal aortic aneurysm (AAA) shares several common pathways with atherosclerosis. Prospective clinical plasma biomarker studies in AAA have been hampered by the need for very large cohorts and long follow-up time. Methods We analyzed a prospective longitudinal cohort of middle-aged individuals from the cardiovascular cohort of the Malmö Diet and Cancer study (n = 5551; 1991-94). The plasma biomarkers lipoprotein-associated phospholipase A2 (Lp-PLA2 activity and mass), proneurotensin and C-reactive protein, and conventional risk factors at baseline were measured in patients with incident AAA during follow-up, and compared to individuals without a diagnosis of AAA. Subjects were... (More)

Background and aims The pathogenesis of abdominal aortic aneurysm (AAA) shares several common pathways with atherosclerosis. Prospective clinical plasma biomarker studies in AAA have been hampered by the need for very large cohorts and long follow-up time. Methods We analyzed a prospective longitudinal cohort of middle-aged individuals from the cardiovascular cohort of the Malmö Diet and Cancer study (n = 5551; 1991-94). The plasma biomarkers lipoprotein-associated phospholipase A2 (Lp-PLA2 activity and mass), proneurotensin and C-reactive protein, and conventional risk factors at baseline were measured in patients with incident AAA during follow-up, and compared to individuals without a diagnosis of AAA. Subjects were followed until December 31st, 2013. Multivariable analyses were expressed in terms of hazard ratios (HR) per 1 standard deviation increment of each respective log-transformed plasma biomarker in the Cox proportional hazard models. Results Cumulative incidence of AAA was 1.5% (men 2.9%, women 0.5%) during a median follow-up period of 20.7 years. Overall, 84 individuals had an incident AAA, of whom 22 (26.2%) were operated on and 16 (19.0%) had ruptured. Mean age of individuals with incident AAA was 59.7 years at study entry and AAA was diagnosed on average 14 years later. When adjusting for age, gender, smoking, body mass index, hypertension, and diabetes mellitus, Lp-PLA2 activity (HR 1.40; 95% CI 1.15–1.72) and Lp-PLA2 mass (HR 1.23; 95% CI 1.00–1.51) were independently associated with incident AAA. Conclusions The plasma biomarkers Lp-PLA2 activity and mass were markers of AAA risk and this implies that AAA is an athero-thrombotic related disease.

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author
organization
publishing date
type
Contribution to journal
publication status
published
subject
keywords
Abdominal aortic aneurysm, Epidemiology, Incident AAA, Lipoprotein-associated phospholipase, Plasma biomarker
in
Atherosclerosis
volume
262
pages
14 - 18
publisher
Elsevier
external identifiers
  • scopus:85019004374
  • wos:000405311200003
ISSN
0021-9150
DOI
10.1016/j.atherosclerosis.2017.04.014
language
English
LU publication?
yes
id
bc4d7cb0-5c32-4d14-9056-3d6430dce6ff
date added to LUP
2017-05-29 11:09:52
date last changed
2017-09-18 11:37:43
@article{bc4d7cb0-5c32-4d14-9056-3d6430dce6ff,
  abstract     = {<p>Background and aims The pathogenesis of abdominal aortic aneurysm (AAA) shares several common pathways with atherosclerosis. Prospective clinical plasma biomarker studies in AAA have been hampered by the need for very large cohorts and long follow-up time. Methods We analyzed a prospective longitudinal cohort of middle-aged individuals from the cardiovascular cohort of the Malmö Diet and Cancer study (n = 5551; 1991-94). The plasma biomarkers lipoprotein-associated phospholipase A2 (Lp-PLA<sub>2</sub> activity and mass), proneurotensin and C-reactive protein, and conventional risk factors at baseline were measured in patients with incident AAA during follow-up, and compared to individuals without a diagnosis of AAA. Subjects were followed until December 31st, 2013. Multivariable analyses were expressed in terms of hazard ratios (HR) per 1 standard deviation increment of each respective log-transformed plasma biomarker in the Cox proportional hazard models. Results Cumulative incidence of AAA was 1.5% (men 2.9%, women 0.5%) during a median follow-up period of 20.7 years. Overall, 84 individuals had an incident AAA, of whom 22 (26.2%) were operated on and 16 (19.0%) had ruptured. Mean age of individuals with incident AAA was 59.7 years at study entry and AAA was diagnosed on average 14 years later. When adjusting for age, gender, smoking, body mass index, hypertension, and diabetes mellitus, Lp-PLA<sub>2</sub> activity (HR 1.40; 95% CI 1.15–1.72) and Lp-PLA<sub>2</sub> mass (HR 1.23; 95% CI 1.00–1.51) were independently associated with incident AAA. Conclusions The plasma biomarkers Lp-PLA<sub>2</sub> activity and mass were markers of AAA risk and this implies that AAA is an athero-thrombotic related disease.</p>},
  author       = {Acosta, Stefan and Taimour, Soumia and Gottsäter, Anders and Persson, Margaretha and Engström, Gunnar and Melander, Olle and Zarrouk, Moncef and Nilsson, Peter M. and Smith, J. Gustav},
  issn         = {0021-9150},
  keyword      = {Abdominal aortic aneurysm,Epidemiology,Incident AAA,Lipoprotein-associated phospholipase,Plasma biomarker},
  language     = {eng},
  month        = {07},
  pages        = {14--18},
  publisher    = {Elsevier},
  series       = {Atherosclerosis},
  title        = {Lp-PLA<sub>2</sub> activity and mass for prediction of incident abdominal aortic aneurysms : A prospective longitudinal cohort study},
  url          = {http://dx.doi.org/10.1016/j.atherosclerosis.2017.04.014},
  volume       = {262},
  year         = {2017},
}