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, James S. 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 Pankow, {James S.} 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",
journal = "Atherosclerosis",
issn = "0021-9150",
publisher = "Elsevier Ireland Ltd",

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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,James S.

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

ER -