title: The prognostic impact of soluble apoptosis-stimulating fragment on mortality in patients with carotid atherosclerosis.
abstract: OBJECTIVE
  Markers of apoptosis are associated with cardiovascular disease. The soluble apoptosis-stimulating fragment (sFAS) was found to be a predictor for outcome in patients with heart failure, but its importance in patients with atherosclerotic disease has not been fully understood as yet. The aim of the present study was to investigate the impact of sFAS on all-cause and cardiovascular mortality in patients with atherosclerosis in the carotid arteries.
  
  
  METHODS
  We studied 981 of 1286 consecutive patients with neurological asymptomatic carotid atherosclerosis as evaluated by duplex Doppler sonography. Patients were prospectively followed for long-term all-cause and cardiovascular mortality.
  
  
  RESULTS
  During a median follow-up of 6.2 years (interquartile range, 5.9 to 6.6 years), a total of 250 deaths (25.5%), including 165 (66%) cardiovascular deaths, were recorded. The risk for all-cause and for cardiovascular mortality, respectively, increased significantly with sFAS concentrations (P<0.001). The hazard ratio for all-cause death was elevated by 2.3-fold (P<0.001) and for cardiovascular death by 2.4-fold (P<0.001) in patients within the highest quintile of sFAS compared with patients within the lowest quintile, respectively. Results remained significant after adjustment for potential confounders and established cardiovascular risk factors, including high-sensitivity C-reactive protein. Patients with high sFAS but low high-sensitivity C-reactive protein had a comparable survival rate with those with elevated high-sensitivity C-reactive protein only (P=0.50).
  
  
  CONCLUSIONS
  Markers of apoptosis, as measured by sFAS, were found to be independent risk predictors for death in patients with atherosclerotic disease in the carotid arteries.
authors.affiliation: Department of Internal Medicine II, Division of Cardiology, Medical University Vienna, Waehringer Guertel 18-20, A-1090 Vienna, Austria.
authors.forename: Matthias
authors.initials: M
authors.lastname: Hoke
authors.forename: Martin
authors.initials: M
authors.lastname: Schillinger
authors.forename: Gerlinde
authors.initials: G
authors.lastname: Zorn
authors.forename: Anna
authors.initials: A
authors.lastname: Wonnerth
authors.forename: Jasmin
authors.initials: J
authors.lastname: Amighi
authors.forename: Wolfgang
authors.initials: W
authors.lastname: Mlekusch
authors.forename: Walter
authors.initials: W
authors.lastname: Speidl
authors.forename: Gerald
authors.initials: G
authors.lastname: Maurer
authors.forename: Renate
authors.initials: R
authors.lastname: Koppensteiner
authors.forename: Erich
authors.initials: E
authors.lastname: Minar
authors.forename: Johann
authors.initials: J
authors.lastname: Wojta
authors.forename: Alexander
authors.initials: A
authors.lastname: Niessner
mesh_terms: D000368:Aged; D015415:Biomarkers / Q000097:blood; D002340:Carotid Artery Diseases / Q000097:blood* / Q000401:mortality*; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D008875:Middle Aged; D011237:Predictive Value of Tests; D011446:Prospective Studies; D015996:Survival Rate; D013997:Time Factors; D019014:fas Receptor / Q000097:blood*
chemical_list: D015415:Biomarkers; C491901:FAS protein, human; D019014:fas Receptor