Department of Angiology, Division of Angiology, Vienna General Hospital, Medical University, Waehringer Guertel 18-20, A-1090 Vienna, Austria.
Stroke. 2011 Jul;42(7):1826-33. doi: 10.1161/STROKEAHA.110.600312. Epub 2011 May 5.
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.
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.
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.
B2M was independently and significantly associated with adverse cardiovascular outcome in patients with prevalent asymptomatic carotid atherosclerosis.
动脉粥样硬化是一种慢性炎症性疾病。持续的炎症与β2 微球蛋白（B2M）水平升高有关。我们调查了颈动脉粥样硬化的大患者队列中 B2M 水平与主要不良心血管事件的发生情况。
1286 例连续的、神经系统无症状的颈动脉粥样硬化患者中，有 1500 例患者接受了中位数为 3 年（四分位距为 2.5 至 3.5）的随访，以观察主要不良心血管事件的发生情况，主要不良心血管事件包括心肌梗死、经皮冠状动脉介入治疗、冠状动脉旁路移植术、卒中和死亡。
我们记录了 271 例（27%）患者中 359 例主要心血管事件。B2M 与主要不良心血管事件的发生显著相关。随着 B2M 四分位的升高，调整后的危险比分别为 1.19（95%可信区间，0.81 至 1.73）、1.51（95%可信区间，1.05 至 2.18）和 1.88（95%可信区间，1.26 至 2.79），与最低四分位相比（P<0.001）。对于 B2M 四分位升高与死亡、心肌梗死和卒中发生的调整后危险比分别为 1.25（95%可信区间，0.92 至 1.70）、1.52（95%可信区间，1.12 至 2.06）和 1.62（95%可信区间，1.16 至 2.67），与最低四分位相比（P<0.001）。通过对风险分层改善的统计估计，B2M 与基线危险因素联合可改善主要心血管事件的风险分层，至少与高敏 C 反应蛋白相当，甚至更好。
B2M 与有症状颈动脉粥样硬化患者不良心血管结局独立且显著相关。
