Abstract
Background: Plasma biomarkers may be useful to detect healthy individuals at increased risk for atherosclerotic manifestations, such as carotid artery stenosis. The aim of this longitudinal cohort study was to evaluate new biomarkers in relation to C-reactive protein and conventional risk factors for carotid artery stenosis during long term follow-up MethodsThe following markers were measured in 5550 middle-aged subjects: C-reactive protein, lipoprotein-associated phospholipase A2, proneurotensin, midregional pro-adrenomedullin, midregional pro-atrial natriuretic peptide, N-terminal pro B-type natriuretic peptide, copeptin, and cystatin C. Subjects with prevalent carotid artery stenosis were excluded. Subjects were followed in national patient registers for 23.4 (interquartile range 19.5–24.3) years regarding incident carotid artery stenosis, both operated and non-operated. ResultsWhen including conventional risk markers in Cox regression, N-terminal pro B-type natriuretic peptide (Hazard ratio 1.36; 95% confidence interval 1.12–1.65; p = 0.002) was independently associated with incident carotid artery stenosis, whereas there were trends for C-reactive protein (HR 1.20; 95% confidence interval 0.98–1.48; p = 0.071), and midregional pro-adrenomedullin (Hazard ratio 1.21; 95% confidence interval 0.99–1.47; p = 0.061). Midregional pro-adrenomedullin (Hazard ratio 1.30; 95% confidence interval 1.03–1.65; p = 0.029) was independently associated with incident surgery for carotid artery stenosis, whereas there was a trend for N-terminal pro B-type natriuretic peptide (Hazard ratio 1.31; 95% confidence interval 1.00–1.72; p = 0.052). ConclusionsN-terminal pro B-type natriuretic peptide and midregional pro-adrenomedullin can be used as predictors for clinically detected carotid artery stenosis during long-term follow-up of healthy subjects.
Highlights
Atherosclerosis is a systemic inflammatory disease which can affect the carotid arteries leading to stenosis, From the *Department of Clinical Sciences, Malmo€, Sweden; †Lund University, Department of Internal and Emergency Medicine, Malmo€, Sweden; and ‡Vascular Centre, Department of Cardiothoracic and Vascular Surgery, Malmo€, Sweden.In addition to traditional atherosclerotic risk factors, plasma biomarkers measured in healthy individuals may be useful to detect individuals at increased risk for developing carotid artery disease, and may serve to identify factors enhancing or halting development of carotid disease
Lipoprotein-associated phospholipase A2 (Lp-PLA2) is an enzyme produced by macrophages, considered as a Journal of Stroke and Cerebrovascular Diseases, Vol 30, No 1 (January), 2021: 105403 biomarker for vascular inflammation and progression of atherosclerosis,[3] and associated with incident ischaemic stroke in meta-analysis.[4]
Sixty-five patients were operated for carotid artery stenosis, 38/2227 men (1.7%) and 27/3316 women (0.8%)
Summary
Plasma biomarkers may be useful to detect healthy individuals at increased risk for atherosclerotic manifestations, such as carotid artery stenosis The aim of this longitudinal cohort study was to evaluate new biomarkers in relation to C-reactive protein and conventional risk factors for carotid artery stenosis during long term follow-up Methods: The following markers were measured in 5550 middle-aged subjects: C-reactive protein, lipoprotein-associated phospholipase A2, proneurotensin, midregional pro-adrenomedullin, midregional pro-atrial natriuretic peptide, N-terminal pro B-type natriuretic peptide, copeptin, and cystatin C. Conclusions: N-terminal pro B-type natriuretic peptide and midregional pro-adrenomedullin can be used as predictors for clinically detected carotid artery stenosis during long-term follow-up of healthy subjects.
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