Beta 2 Microglobulin and the Risk for Cardiovascular Events in Patients With Asymptomatic Carotid Atherosclerosis
Beta 2 Microglobulin and the Risk for Cardiovascular Events in Patients With Asymptomatic Carotid Atherosclerosis
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DOI：
10.1161/strokeaha.110.600312
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发表时间：
2011-07-01
期刊：
影响因子：
8.3
通讯作者：
Wagner, Oswald
中科院分区：
文献类型：
--
作者：
Amighi, Jasmin;Hoke, Matthias;Wagner, Oswald
背景和目的动脉粥样硬化是一种慢性炎症性疾病。持续的炎症与β 2微球蛋白（B2 M）水平升高有关。我们调查了一个大的颈动脉粥样硬化患者队列中B2 M水平与主要不良心血管事件发生的关系。方法：1286例连续的、神经学上无症状的颈动脉粥样硬化患者中有1005例被随访，中位数为3年（四分位距，2.5 - 3.5）主要不良心血管事件的发生率，包括心肌梗死、经皮冠状动脉介入治疗，结果：我们记录了271例（27%）患者的359例主要心血管事件。B2 M与主要不良心血管事件的发生显著相关。随着B2 M四分位数的增加，与最低四分位数相比，调整后的风险比分别为1.19（95%CI，0.81至1.73）、1.51（95%CI，1.05至2.18）和1.88（95%CI，1.26至2.79）（P < 0.001）。与最低四分位数相比，B2 M增加四分位数时死亡、心肌梗死和卒中发生的校正风险比分别为1.25（95%CI，0.92 - 1.70）、1.52（95%CI，1.12 - 2.06）和1.62（95%CI，1.16 - 2.67）（P < 0.001）。通过统计学估计的改善风险分层，除了B2 M的基线风险因素改善了主要心血管事件的风险分层，至少一样多的高敏C反应蛋白，甚至更好。结论-B2 M是独立的，并显着与不良心血管事件的结果与患者的无症状颈动脉粥样硬化。（中风。2011; 42：1826-1833.）
Background and Purpose-Atherosclerosis is a chronic inflammatory disease. Ongoing inflammation is associated with elevated levels of beta 2 microglobulin (B2M). We investigated B2M levels in a large cohort of patients with carotid atherosclerosis for the occurrence of major adverse cardiovascular events.Methods-One thousand five of 1286 consecutive, neurologically asymptomatic patients with carotid atherosclerosis were followed for a median of 3 years (interquartile range, 2.5 to 3.5) for the occurrence of major adverse cardiovascular events, a composite of myocardial infarction, percutaneous coronary intervention, coronary bypass graft, stroke, and death.Results-We recorded 359 major cardiovascular events in 271 (27%) patients. B2M was significantly associated with the occurrence of major adverse cardiovascular events. With increasing quartiles of B2M, the adjusted hazard ratios were 1.19 (95% CI, 0.81 to 1.73), 1.51 (95% CI, 1.05 to 2.18), and 1.88 (95% CI, 1.26 to 2.79) compared with the lowest quartile, respectively (P < 0.001). Adjusted hazard ratios for the occurrence of death, myocardial infarction, and stroke for increasing quartiles of B2M were 1.25 (95% CI, 0.92 to 1.70), 1.52 (95% CI, 1.12 to 2.06), and 1.62 (95% CI, 1.16 to 2.67) compared with the lowest quartile, respectively (P < 0.001). Through statistical estimation of improvement in risk stratification, addition of B2M to baseline risk factors improved the risk stratification for major cardiovascular events, at least as much as high-sensitivity C-reactive protein or even better.Conclusions-B2M was independently and significantly associated with adverse cardiovascular outcome in patients with prevalent asymptomatic carotid atherosclerosis. (Stroke. 2011; 42: 1826-1833.)