The alternative complement pathway is longitudinally associated with adverse cardiovascular outcomes The CODAM study

Elisabeth Hertle, Ilja C. W. Arts, Carla J. H. van der Kallen, Edith J. M. Feskens, Casper G. Schalkwijk, Coen D. A. Stehouwer, Marleen M. J. van Greevenbroek*

*Corresponding author for this work

Research output: Contribution to journalArticleAcademicpeer-review

26 Citations (Web of Science)


The alternative pathway of complement activation is highly reactive and can be activated spontaneously in the vasculature. Activation may contribute to vascular damage and development of cardiovascular disease (CVD). We aimed to investigate functional components of the alternative pathway in cardiovascular risk. We studied 573 individuals who were followed-up for seven years. At baseline, we measured the enhancer properdin; the rate-limiting protease factor D (FD); and a marker of systemic activation, Bb. Using generalised estimating equations, we investigated their longitudinal associations with cardiovascular events (CVE, N=89), CVD (N=159), low-grade inflammation (LGI), endothelial dysfunction (ED) and carotid intima-media thickness (cIMT). Furthermore, we investigated associations with incident CVE (N=39) and CVD (N=73) in 342 participants free of CVD at baseline. CVE included myocardial infarction, stroke, cardiac angioplasty and/or cardiac bypass. CVD additionally included ischaemia on an electrocardiogram and/or ankle-brachial index
Original languageEnglish
Pages (from-to)446-457
Number of pages12
JournalThrombosis and Haemostasis
Issue number2
Publication statusPublished - Feb 2016


  • Alternative complement pathway
  • properdin
  • cardiovascular events
  • endothelial dysfunction

Cite this