Inflammatory Markers are Associated with the Abdominal Aortic Diameter

Abstract number: P1282

Miniati¹ B, Macchi¹ C, Marcucci² R, Gori² AM, Conti¹ AA, Corsi³ AM, Bandinelli³ S, Ferrucci⁴ L, Abbate² R, Gensini² GF

¹¹Fondazione Don Gnocchi IRCCS, Florence, Italy ²²Department of Medical and Surgical Critical Area, Thrombosis Centre, University of Florence, Italy ²²Department of Medical and Surgical Critical Area, Thrombosis Centre, University of Florence, Italy ³³Laboratory of Clinical Epidemiology, Geriatric Department, National Institute of Research and Care on Aging (INRCA), Florence, Italy ⁴⁴Longitudinal Studies Section, Gerontology Research Center, National Institute on Aging, National Institutes of Health, Baltimore, USA

The inflammatory response plays a crucial role in the degeneration of the elastic media, which, in turn, promotes aneurysm remodeling of the aortic wall. Degeneration of the extracellular matrix proteins, which characterizes the alteration of the elastic media of abdominal aortic aneurysms, is a pathological process that occurs as a consequence of complex interactions among genetic factors, inflammatory cytokines and matrix metalloproteases. Aim of our study was to evaluate the relationship between inflammatory proteins and aortic diameter. We studied 346 participants of the In Chianti Study (151 males and 195 females) (median age 70, 23–93 years). In all subjects, we evaluated C-Reactive Protein (CRP), interleukin-18 (IL-18), interleukin-6 (IL-6), interleukin 1-Beta (IL-1Beta), transforming growth factor Beta1 (TGF-Beta1), and tumor necrosis factor-alpha (TNF-alpha) serum levels and the abdominal aortic diameter by ultrasound scanning examination. The association between chronic inflammation on aortic diameter was tested in the multivariate regression analysis, which included log-transformed aortic diameter as dependent variable and age, sex, hypertension, diabetes, coronary artery disease, body mass index, dyslipidemia, smoking habit and inflammatory markers as independent variables. We observed that the circulating levels of IL-18 and CRP significantly associated with abdominal aortic diameter. At multivariate logistic regression analysis, after adjustment for traditional cardiovascular risk factors, subjects who had IL-18 serum levels in the highest tertile compared to the lowest tertile of the distribution had an increased risk of being in the highest (>19 mm) aortic diameter group (OR = 4.0, 95% CI 1.3–11.7, P= 0.02). High levels of CRP (top tertile vs lowest tertile) are associated, but not significantly, with an increased risk of having high aortic diameter (OR = 1.3 95% CI 0.8–2.0 for aortic diameter >19 mm). These results strengthen the concept of a possible link between inflammation and aortic remodelling.