Abstract 14810: Biomarkers’ Association With Incident Cardiovascular Events is Not Modified by Presence/Severity of Sub Clinical Carotid Atherosclerosis: The Atherosclerosis Risk in Communities (ARIC) Study
Introduction: Circulating biomarkers and subclinical atherosclerosis (SCA), measured using tools such carotid intima media thickness (CIMT), have shown association with incident cardiovascular disease (CVD). Whether presence of SCA is a required for the association between biomarkers and CVD is unknown. We hypothesized that the strength of association between biomarkers and incident CVD depends on the presence of SCA.
Methods: From 10,046 ARIC visit 4 participants, we excluded those with prevalent CVD, those missing biomarkers, CV risk factors and CIMT information which left 5910 individuals eligible for the analysis. Biomarkers tested included high sensitivity C-reactive protein (CRP), lipoprotein associated phospholipase A2 (LpPLA2), lipoprotein (a), cardiac troponin T, NTproB type natriuretic peptide, cystatin c and urine albumin creatinine ratio. Common CIMT>75th percentile and presence of plaque was defined as significant SCA, common CIMT<25th percentile and absence of plaque as minimal SCA and others as moderate SCA. Adjusted Cox-proportional hazards models and tests of interaction (table) were used to study the association between the biomarkers and incident CVD stratified by SCA.
Results: The mean age of the population was 62.6 years (80% white, 58% women, 43% hypertensive, 13% diabetic). Over a mean follow up of 12.1 ± 3.3 years there were 610 incident CVD events. While there were some numerical changes in the hazards for incident CVD by SCA category (table), overall there was no significant interaction between biomarkers and SCA categories. The results were similar when the association between biomarkers and coronary heart disease and stroke were tested except CRP demonstrated a significant interaction with SCA for stroke incidence.
Conclusion: The association of biomarkers with incident CVD does not appear to be dependent on SCA which suggests that both biomarkers and SCA may have complementary value in the assessment of CVD.
- © 2013 by American Heart Association, Inc.