title: Beta 2 microglobulin and the risk for cardiovascular events in patients with asymptomatic carotid atherosclerosis.
abstract: OBJECTIVE
  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.
authors.affiliation: Department of Angiology, Division of Angiology, Vienna General Hospital, Medical University, Waehringer Guertel 18-20, A-1090 Vienna, Austria. jasmin.amighi@meduniwien.ac.at
authors.forename: Jasmin
authors.initials: J
authors.lastname: Amighi
authors.forename: Matthias
authors.initials: M
authors.lastname: Hoke
authors.forename: Wolfgang
authors.initials: W
authors.lastname: Mlekusch
authors.forename: Oliver
authors.initials: O
authors.lastname: Schlager
authors.forename: Markus
authors.initials: M
authors.lastname: Exner
authors.forename: Markus
authors.initials: M
authors.lastname: Haumer
authors.forename: Elisabeth
authors.initials: E
authors.lastname: Pernicka
authors.forename: Renate
authors.initials: R
authors.lastname: Koppensteiner
authors.forename: Erich
authors.initials: E
authors.lastname: Minar
authors.forename: Helmut
authors.initials: H
authors.lastname: Rumpold
authors.forename: Martin
authors.initials: M
authors.lastname: Schillinger
authors.forename: Oswald
authors.initials: O
authors.lastname: Wagner
mesh_terms: D000368:Aged; D015415:Biomarkers / Q000378:metabolism; D002318:Cardiovascular Diseases / Q000150:complications* / Q000175:diagnosis; D002340:Carotid Artery Diseases / Q000097:blood / Q000150:complications*; D015331:Cohort Studies; D005260:Female; D006801:Humans; D006973:Hypertension; D007249:Inflammation; D008297:Male; D008875:Middle Aged; D009203:Myocardial Infarction / Q000378:metabolism; D058226:Plaque, Atherosclerotic / Q000097:blood / Q000150:complications*; D016016:Proportional Hazards Models; D001613:beta 2-Microglobulin / Q000096:biosynthesis*
chemical_list: D015415:Biomarkers; D001613:beta 2-Microglobulin