Circulating Biomarkers and Abdominal Aortic Aneurysm Incidence: The Atherosclerosis Risk in Communities (ARIC) Study

Aaron R. Folsom, Lu Yao, Alvaro Alonso, Pamela L. Lutsey, Emil Missov, Frank A. Lederle, Christie M. Ballantyne, Weihong Tang

Research output: Contribution to journalArticlepeer-review

81 Scopus citations


Background - The pathogenesis of abdominal aortic aneurysm (AAA) is complex. Cross-sectional studies have connected circulating biomarkers with AAA, but prospective evidence is limited. Methods and Results - In the Atherosclerosis Risk in Communities Study cohort, we measured multiple blood biomarkers of inflammation, hemostasis, thrombin generation, cardiac dysfunction, and vascular stiffness and identified incident AAAs during follow-up using hospital discharge codes. Six biomarkers (white blood cell count, fibrinogen, D-dimer, troponin T, N-terminal pro-brain natriuretic peptide, and high-sensitivity C-reactive protein) were strongly associated positively with AAA incidence. Compared with having none of these 6 biomarkers in the highest quartile, the hazard ratios of AAA for those with 1, 2, 3, or 4 to 6 biomarkers in the highest quartile were 2.2, 3.3, 4.0, and 9.9, respectively (P for trend < 0.0001) after adjustment for other risk factors. Conclusions - This prospective study found that higher concentrations of 6 biomarkers were associated with increased risk of AAA. The more markers that fell into the highest quartile, the higher the AAA risk was. Multiple positive biomarkers identify a subgroup of patients at high risk of AAA.

Original languageEnglish (US)
Pages (from-to)578-585
Number of pages8
Issue number7
StatePublished - Aug 18 2015

Bibliographical note

Publisher Copyright:
© 2015 American Heart Association, Inc.


  • aortic aneurysm, abdominal
  • cohort studies
  • risk factors


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