Incidence of fatal or repaired abdominal aortic aneurysm in relation to inflammation-sensitive plasma proteins

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, alpha1-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 greater than or equal to3 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.