| Popis: |
The primary aim of this study was to test which of a group of four inflammation and thrombosis biomarkers were independently predictive of major adverse cardiovascular events (MACE) in patients with small abdominal aortic aneurysm (AAA).471 participants with a 30 to 54mm AAA had serum C-reactive protein (CRP), fibrinogen, neutrophil-lymphocyte ratio (NLR) and homocysteine measured. The primary outcome was MACE which was defined as the first occurrence of myocardial infarction, stroke or cardiovascular death. The association of biomarkers with events was assessed using Kaplan Meier and Cox proportional hazard analyses. The net improvement in risk of event categorization with addition of a biomarker to clinical risk factors alone was assessed using net reclassification index (NRI).Participants were followed for a median of 2.4 (inter-quartile range 0.8, 5.4) years and 102 (21.7%) had a MACE. The incidence of MACE was 13.2% in participants with CRP3.0 mg/L compared to 10.1% in those with CRP ≤ 3.0 mg/L at 2.5 years (p=0.047). After adjusting for other risk factors, higher CRP was associated with a significantly higher risk of MACE (HR 1.19, 95% CI 1.05, 1.35). None of the other biomarkers were associated with the risk of MACE. According to NRI, CRP significantly improved the risk classification of MACE compared to clinical risk factors alone.CRP can assist in classification of risk of MACE for patients with small AAA. |
