Association of carotid atherosclerosis and stiffness with abdominal aortic aneurysm: The atherosclerosis risk in communities (ARIC) study

Lu Yao, Aaron R Folsom, Alvaro Alonso, Pamela L Lutsey, Jim Pankow, Weihua Guan, Susan Cheng, Frank A. Lederle, Weihong Tang

Research output: Contribution to journalArticle

Abstract

Background and aims: Individuals with atherosclerosis and stiffness often have increased abdominal aortic diameters, but prospective evidence linking them to the risk of abdominal aortic aneurysm (AAA) is limited. Methods: We prospectively examined the relationship of carotid atherosclerosis and stiffness with future risk of AAA in ARIC. At Visits 1 (1987–89) or 2 (1990–1992), we assessed carotid atherosclerosis (represented by greater carotid intima-media thickness [cIMT] or presence of atherosclerotic plaque) and lower carotid distensibility (reflected by a higher carotid Beta Index). We identified incident, clinical AAAs during follow-up through 2011 using hospital discharge codes, Medicare outpatient diagnoses, or death certificates. Results: Participants’ mean age at baseline was 54.2 years (SD 5.8), 45% were male and 73% white. During a median of 22.5 years of follow-up, 542 clinical AAAs were ascertained. After multivariable adjustment, the presence of carotid atherosclerotic plaque at baseline was associated with 1.31 (95% CI: 1.10–1.57; p = 0.003) times higher risk of clinical AAA. Greater cIMT and Beta Index were also associated with clinical AAA with a dose-response across quartiles (p trend for both: 0.006; hazard ratios [95% CI] for the highest vs. lowest quartiles: 1.55 [1.13–2.11] and 1.68 [1.16–2.43], respectively). The associations of cIMT and Beta Index with AAA were independent of each other. Conclusions: This prospective population-based study found that indices of greater carotid atherosclerosis and lower carotid distensibility are markers of increased AAA risk.

LanguageEnglish (US)
Pages110-116
Number of pages7
JournalAtherosclerosis
Volume270
DOIs
StatePublished - Mar 1 2018

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Carotid Artery Diseases
Abdominal Aortic Aneurysm
Atherosclerosis
Carotid Intima-Media Thickness
Atherosclerotic Plaques
Death Certificates
Medicare
Outpatients
Population

Keywords

  • Abdominal aortic aneurysm
  • Atherosclerosis
  • Carotid distensibility
  • Carotid intima-media thickness
  • Carotid plaque

PubMed: MeSH publication types

  • Journal Article

Cite this

@article{776bf74df8864e71b347cae382274879,
title = "Association of carotid atherosclerosis and stiffness with abdominal aortic aneurysm: The atherosclerosis risk in communities (ARIC) study",
abstract = "Background and aims: Individuals with atherosclerosis and stiffness often have increased abdominal aortic diameters, but prospective evidence linking them to the risk of abdominal aortic aneurysm (AAA) is limited. Methods: We prospectively examined the relationship of carotid atherosclerosis and stiffness with future risk of AAA in ARIC. At Visits 1 (1987–89) or 2 (1990–1992), we assessed carotid atherosclerosis (represented by greater carotid intima-media thickness [cIMT] or presence of atherosclerotic plaque) and lower carotid distensibility (reflected by a higher carotid Beta Index). We identified incident, clinical AAAs during follow-up through 2011 using hospital discharge codes, Medicare outpatient diagnoses, or death certificates. Results: Participants’ mean age at baseline was 54.2 years (SD 5.8), 45{\%} were male and 73{\%} white. During a median of 22.5 years of follow-up, 542 clinical AAAs were ascertained. After multivariable adjustment, the presence of carotid atherosclerotic plaque at baseline was associated with 1.31 (95{\%} CI: 1.10–1.57; p = 0.003) times higher risk of clinical AAA. Greater cIMT and Beta Index were also associated with clinical AAA with a dose-response across quartiles (p trend for both: 0.006; hazard ratios [95{\%} CI] for the highest vs. lowest quartiles: 1.55 [1.13–2.11] and 1.68 [1.16–2.43], respectively). The associations of cIMT and Beta Index with AAA were independent of each other. Conclusions: This prospective population-based study found that indices of greater carotid atherosclerosis and lower carotid distensibility are markers of increased AAA risk.",
keywords = "Abdominal aortic aneurysm, Atherosclerosis, Carotid distensibility, Carotid intima-media thickness, Carotid plaque",
author = "Lu Yao and Folsom, {Aaron R} and Alvaro Alonso and Lutsey, {Pamela L} and Jim Pankow and Weihua Guan and Susan Cheng and Lederle, {Frank A.} and Weihong Tang",
year = "2018",
month = "3",
day = "1",
doi = "10.1016/j.atherosclerosis.2018.01.044",
language = "English (US)",
volume = "270",
pages = "110--116",
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TY - JOUR

T1 - Association of carotid atherosclerosis and stiffness with abdominal aortic aneurysm

T2 - Atherosclerosis

AU - Yao, Lu

AU - Folsom, Aaron R

AU - Alonso, Alvaro

AU - Lutsey, Pamela L

AU - Pankow, Jim

AU - Guan, Weihua

AU - Cheng, Susan

AU - Lederle, Frank A.

AU - Tang, Weihong

PY - 2018/3/1

Y1 - 2018/3/1

N2 - Background and aims: Individuals with atherosclerosis and stiffness often have increased abdominal aortic diameters, but prospective evidence linking them to the risk of abdominal aortic aneurysm (AAA) is limited. Methods: We prospectively examined the relationship of carotid atherosclerosis and stiffness with future risk of AAA in ARIC. At Visits 1 (1987–89) or 2 (1990–1992), we assessed carotid atherosclerosis (represented by greater carotid intima-media thickness [cIMT] or presence of atherosclerotic plaque) and lower carotid distensibility (reflected by a higher carotid Beta Index). We identified incident, clinical AAAs during follow-up through 2011 using hospital discharge codes, Medicare outpatient diagnoses, or death certificates. Results: Participants’ mean age at baseline was 54.2 years (SD 5.8), 45% were male and 73% white. During a median of 22.5 years of follow-up, 542 clinical AAAs were ascertained. After multivariable adjustment, the presence of carotid atherosclerotic plaque at baseline was associated with 1.31 (95% CI: 1.10–1.57; p = 0.003) times higher risk of clinical AAA. Greater cIMT and Beta Index were also associated with clinical AAA with a dose-response across quartiles (p trend for both: 0.006; hazard ratios [95% CI] for the highest vs. lowest quartiles: 1.55 [1.13–2.11] and 1.68 [1.16–2.43], respectively). The associations of cIMT and Beta Index with AAA were independent of each other. Conclusions: This prospective population-based study found that indices of greater carotid atherosclerosis and lower carotid distensibility are markers of increased AAA risk.

AB - Background and aims: Individuals with atherosclerosis and stiffness often have increased abdominal aortic diameters, but prospective evidence linking them to the risk of abdominal aortic aneurysm (AAA) is limited. Methods: We prospectively examined the relationship of carotid atherosclerosis and stiffness with future risk of AAA in ARIC. At Visits 1 (1987–89) or 2 (1990–1992), we assessed carotid atherosclerosis (represented by greater carotid intima-media thickness [cIMT] or presence of atherosclerotic plaque) and lower carotid distensibility (reflected by a higher carotid Beta Index). We identified incident, clinical AAAs during follow-up through 2011 using hospital discharge codes, Medicare outpatient diagnoses, or death certificates. Results: Participants’ mean age at baseline was 54.2 years (SD 5.8), 45% were male and 73% white. During a median of 22.5 years of follow-up, 542 clinical AAAs were ascertained. After multivariable adjustment, the presence of carotid atherosclerotic plaque at baseline was associated with 1.31 (95% CI: 1.10–1.57; p = 0.003) times higher risk of clinical AAA. Greater cIMT and Beta Index were also associated with clinical AAA with a dose-response across quartiles (p trend for both: 0.006; hazard ratios [95% CI] for the highest vs. lowest quartiles: 1.55 [1.13–2.11] and 1.68 [1.16–2.43], respectively). The associations of cIMT and Beta Index with AAA were independent of each other. Conclusions: This prospective population-based study found that indices of greater carotid atherosclerosis and lower carotid distensibility are markers of increased AAA risk.

KW - Abdominal aortic aneurysm

KW - Atherosclerosis

KW - Carotid distensibility

KW - Carotid intima-media thickness

KW - Carotid plaque

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U2 - 10.1016/j.atherosclerosis.2018.01.044

DO - 10.1016/j.atherosclerosis.2018.01.044

M3 - Article

VL - 270

SP - 110

EP - 116

JO - Atherosclerosis

JF - Atherosclerosis

SN - 0021-9150

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