Lp-PLA2 activity and mass for prediction of incident abdominal aortic aneurysms: A prospective longitudinal cohort study.
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.
['Acosta|Stefan|S|', 'Taimour|Soumia|S|', 'Gottsäter|Anders|A|', 'Persson|Margaretha|M|', 'Engström|Gunnar|G|', 'Melander|Olle|O|', 'Zarrouk|Moncef|M|', 'Nilsson|Peter M|PM|', 'Smith|J Gustav|JG|']
D043203:1-Alkyl-2-acetylglycerophosphocholine Esterase D017544:Aortic Aneurysm, Abdominal D001019:Aortic Rupture D015415:Biomarkers D002097:C-Reactive Protein D005260:Female D006801:Humans D015994:Incidence D008137:Longitudinal Studies D008297:Male D008875:Middle Aged D015999:Multivariate Analysis D009496:Neurotensin D011237:Predictive Value of Tests D011379:Prognosis D016016:Proportional Hazards Models D011446:Prospective Studies D011498:Protein Precursors D012307:Risk Factors D013548:Sweden D013997:Time Factors
Abdominal aortic aneurysm Plasma biomarker Lipoprotein-associated phospholipase Incident AAA Epidemiology