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(Arteriosclerosis, Thrombosis, and Vascular Biology. 2004;24:337.)
© 2004 American Heart Association, Inc.

Atherosclerosis and Lipoproteins

Incidence of Fatal or Repaired Abdominal Aortic Aneurysm in Relation to Inflammation-Sensitive Plasma Proteins

Gunnar Engström; Gabriel Börner; Bengt Lindblad; Lars Janzon; Folke Lindgärde

From the Departments of Community Medicine (G.E., L.J.), Vascular Surgery (G.B., B.L.), and Vascular Diseases (F.L.), Lund University, Malmö University Hospital, Sweden.

Correspondence to Gunnar Engström, MD, PhD, Department of Community Medicine, Malmö University Hospital, S-20502 Malmö, Sweden. E-mail Gunnar.Engstrom{at}smi.mas.lu.se

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.

Methods and Results— Five ISPs (fibrinogen, orosomucoid, 1-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 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).

Conclusion— 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.

Key Words: aneurysm • inflammation • epidemiology