Increased serum angiopoietin-2 is associated with abdominal aortic aneurysm prevalence and cardiovascular mortality in older men

Abstract

Background: Angiopoietin-2 (Angpt2) has been implicated in the mediation and regulation of angiogenesis and inflammation which are believed to be critical mechanisms in the pathogenesis of both abdominal aortic aneurysm (AAA) and cardiovascular events. The aim of this study was to assess whether serum Angpt2 was associated with the prevalence of AAA and the occurrence of cardiovascular mortality in older men.

Methods: A cohort of 997 elderly men was recruited in 1996-99. Aortic ultrasound identified an AAA in 308 (31%). In 2001-04, blood was collected and serum Angpt2 later measured by immunoassay. The association of Angpt2 with AAA was assessed using multiple regression analysis. All men were followed by means of the Western Australia Data Linkage System until July 31st 2009. The association of Angpt2 with cardiovascular mortality was assessed using Cox proportional hazard analysis.

Results: Median serum Angpt2 was significantly higher (3.16 ng/ml, inter-quartile range 2.51-4.54) in men with AAA compared with men without AAA (2.70 ng/ml, inter-quartile range 2.03-3.72; p<0.001). After adjusting for cardiovascular risk factors, men with serum Angpt2 in the highest quartile (>3.95 ng/ml) had a 2.57-fold (95% CI 1.66-3.97, p<0.001) increased odds of AAA and a 4.12-fold (95% CI 1.90-8.94, p<0.001) increased relative risk of cardiovascular mortality compared to men with serum Angpt2 in the lowest quartile (<2.13 ng/ml).

Conclusions: Serum Angpt2 is elevated in men with AAA and associated with an increased risk of cardiovascular mortality in older men.

Keywords: Abdominal aortic aneurysm; Angiopoietin-2; Cardiovascular deaths.