Objective-Atherosclerotic cardiovascular disease is a major burden to health care. Because atherosclerosis is considered a systemic disease, we hypothesized that one single atherosclerotic plaque contains ample molecular information that predicts future cardiovascular events in all vascular territories. Methods and Results-AtheroExpress is a biobank collecting atherosclerotic lesions during surgery, with a 3-year follow-up. The composite primary outcome encompasses all cardiovascular events and interventions, eg, cardiovascular death, myocardial infarction, stroke, and endovascular interventions. A proteomics search identified osteopontin as a potential plaque biomarker. Patients undergoing carotid surgery (n=574) served as the cohort in which plaque osteopontin levels were examined in relation to their outcome during follow-up and was validated in a cohort of patients undergoing femoral endarterectomy (n=151). Comparing the highest quartile of carotid plaque osteopontin levels with quartile 1 showed a hazard ratio for the primary outcome of 3.8 (95% confidence interval, 2.6-5.9). The outcome did not change after adjustment for plaque characteristics and traditional risk factors (hazard ratio, 3.5; 95% confidence interval, 2.0-5.9). The femoral validation cohort showed a hazard ratio of 3.8 (95% confidence interval 2.0 to 7.4) comparing osteopontin levels in quartile 4 with quartile 1. Conclusion-Plaque osteopontin levels in single lesions are predictive for cardiovascular events in other vascular territories. Local atherosclerotic plaques are a source of prognostic biomarkers with a high predictive value for secondary manifestations of atherosclerotic disease.

Arterectomy, Atherosclerosis, Biomarker, Plaque, adverse outcome, aged, article, atherosclerotic plaque, bioinformatics, biological marker, carotid artery surgery, controlled study, endarterectomy, enzyme linked immunosorbent assay, female, femur, follow up, heart death, heart infarction, human, major clinical study, male, osteopontin, outcome assessment, priority journal, prognosis, protein analysis, protein blood level, protein purification, proteomics, risk assessment, stroke
dx.doi.org/10.1161/ATVBAHA.109.194944, hdl.handle.net/1765/19914
Arteriosclerosis, Thrombosis, and Vascular Biology
Erasmus MC: University Medical Center Rotterdam

de Kleijn, D.P.V, Moll, F.L, Hellings, W.E, Ozsarlak-Sozer, G, de Bruin, P, Doevendans, P.A, … Pasterkamp, G. (2010). Local atherosclerotic plaques are a source of prognostic biomarkers for adverse cardiovascular events. Arteriosclerosis, Thrombosis, and Vascular Biology, 30(3), 612–619. doi:10.1161/ATVBAHA.109.194944