This Article Full Text Full Text (PDF) All Versions of this Article: 110/7/862    most recent 01.CIR.0000138746.14425.00v1 Alert me when this article is cited Alert me if a correction is posted Citation Map Services Email this article to a friend Similar articles in this journal Similar articles in PubMed Alert me to new issues of the journal Download to citation manager Request Permissions Citing Articles Citing Articles via HighWire Citing Articles via Google Scholar Google Scholar Articles by Norman, P. Articles by Jamrozik, K. Search for Related Content PubMed PubMed Citation Articles by Norman, P. Articles by Jamrozik, K. Pubmed/NCBI databases Substance via MeSH Related Collections Other diagnostic testing CV surgery: aortic and vascular disease

(Circulation. 2004;110:862-866.)
© 2004 American Heart Association, Inc.

Original Articles

C-Reactive Protein Levels and the Expansion of Screen-Detected Abdominal Aortic Aneurysms in Men

From the School of Surgery and Pathology, The University of Western Australia, Fremantle Hospital, Fremantle, Western Australia (P.N.); the School of Population Health, The University of Western Australia, Perth, Western Australia (C.A.S., K.J.); The Mount Hospital, Perth, Western Australia (M.M.L.-B.); and the Department of Primary Health Care and General Practice, and Imperial College London (K.J.).

Correspondence to Prof Paul Norman, School of Surgery and Pathology, Fremantle Hospital, PO Box 480, Fremantle, Western Australia 6959. E-mail pnorman{at}cyllene.uwa.edu.au

Received September 2, 2003; de novo received February 6, 2003; accepted April 13, 2004.

Background— C-reactive protein (CRP) levels have been shown to predict a number of cardiovascular outcomes. CRP levels have also been found to be elevated in patients with abdominal aortic aneurysms (AAAs). The aim of this study was to assess the relation between CRP levels and rates of expansion of small AAAs.

Methods and Results— A cohort of men with small aneurysms was identified in a trial of screening with ultrasound scanning. After initial screening, men were rescanned at 6- to 12-month intervals. CRP levels were measured at the first follow-up visit. Rates of expansion and risk factors for expansion were assessed with the use of data from 545 men who attended for at least 1 scan after CRP levels were measured. These men were followed for a median of 48 (range, 5 to 69) months. The mean annual rate of expansion was 1.6 mm. The median CRP level was 2.6 mg/L in men with the smaller AAAs (30 to 39 mm, n=433) compared with 3.5 mg/L in men with larger AAAs (40 to 54 mm, n=112) (P=0.007). The multivariate age-adjusted logistic model confirmed initial aortic diameter to be the only factor associated with rapid expansion with an odds ratio of 7.2 (95% CI, 4.3,12.2) for an initial diameter of 40 to 54 mm relative to one of 30 to 39 mm.

Conclusions— Most small aneurysms expand slowly. CRP levels are elevated in larger aneurysms but do not appear to be associated with rapid expansion. The most useful predictor of aneurysmal expansion in men is aortic diameter.

Key Words: aorta • aneurysm • proteins • risk factors

This article has been cited by other articles:

				P. E Norman, L. Flicker, O. P Almeida, G. J Hankey, Z. Hyde, and K. Jamrozik Cohort Profile: The Health In Men Study (HIMS) Int. J. Epidemiol., March 3, 2008; (2008) dyn041v1. [Full Text] [PDF]

				J. Golledge, M. Karan, C. S. Moran, J. Muller, P. Clancy, A. E. Dear, and P. E. Norman Reduced expansion rate of abdominal aortic aneurysms in patients with diabetes may be related to aberrant monocyte-matrix interactions Eur. Heart J., March 1, 2008; 29(5): 665 - 672. [Abstract] [Full Text] [PDF]

				J. Golledge, P. Clancy, K. Jamrozik, and P. E. Norman Obesity, Adipokines, and Abdominal Aortic Aneurysm: Health in Men Study Circulation, November 13, 2007; 116(20): 2275 - 2279. [Abstract] [Full Text] [PDF]

				K. Inoue, A. Sugiyama, P. C. Reid, Y. Ito, K. Miyauchi, S. Mukai, M. Sagara, K. Miyamoto, H. Satoh, I. Kohno, et al. Establishment of a High Sensitivity Plasma Assay for Human Pentraxin3 as a Marker for Unstable Angina Pectoris Arterioscler. Thromb. Vasc. Biol., January 1, 2007; 27(1): 161 - 167. [Abstract] [Full Text] [PDF]

				J. Golledge, J. Muller, A. Daugherty, and P. Norman Abdominal Aortic Aneurysm: Pathogenesis and Implications for Management Arterioscler. Thromb. Vasc. Biol., December 1, 2006; 26(12): 2605 - 2613. [Abstract] [Full Text] [PDF]

				S. Shiraya, K. Miwa, M. Aoki, T. Miyake, M. Oishi, K. Kataoka, S. Ohgi, T. Ogihara, Y. Kaneda, and R. Morishita Hypertension Accelerated Experimental Abdominal Aortic Aneurysm Through Upregulation of Nuclear Factor {kappa}B and Ets Hypertension, October 1, 2006; 48(4): 628 - 636. [Abstract] [Full Text] [PDF]

				C. S. Moran, M. McCann, M. Karan, P. Norman, N. Ketheesan, and J. Golledge Association of Osteoprotegerin With Human Abdominal Aortic Aneurysm Progression Circulation, June 14, 2005; 111(23): 3119 - 3125. [Abstract] [Full Text] [PDF]