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Aldosterone, atherosclerosis and vascular events in patients with stable coronary artery disease.

Abstract：

BACKGROUND AND AIMS:Plasma aldosterone has been associated with all-cause and cardiovascular mortality in high-risk cardiovascular populations, including patients with heart failure, myocardial infarction and high-risk coronary artery disease (CAD) patients. In the present study, we evaluated the association of plasma aldosterone levels with vascular events in a large prospective cohort of stable CAD patients recruited in an outpatient setting. Moreover, we investigated the relationship between aldosterone and atherosclerotic burden. METHODS AND RESULTS:Baseline plasma aldosterone levels were measured in 2699 subjects with CAD (mean age 60 ± 10 years, 82% male). During a median follow-up of 4.7 years, 308 (11%) patients died, of which 203 were from a vascular cause. Vascular endpoints of myocardial infarction, ischemic stroke or vascular death occurred in 355 (13%) patients. Multivariable Cox regression analysis was performed, adjusting for multiple confounders. Aldosterone (median 96 pg/mL, interquartile range 70-138 pg/mL, normal range 58-362 pg/mL) was independently associated with major vascular events (hazard ratio (HR) 1.56, 95% confidence interval (CI) 1.13-2.15) and vascular mortality (HR 1.95, 95% CI 1.27-3.00). By multivariable regression analysis, aldosterone was also associated with the presence of atherosclerosis in additional vascular territories (cerebrovascular disease and/or peripheral artery disease) (p=0.026). CONCLUSIONS:In patients with stable coronary artery disease, plasma aldosterone is independently associated with the risk of major vascular events and vascular mortality and with atherosclerotic burden.

journal_name

Int J Cardiol

journal_title

International journal of cardiology

authors

Hillaert MA,Lentjes EG,Kemperman H,van der Graaf Y,Nathoe HM,Beygui F,Montalescot G,Doevendans PA,Wassink AM,van Belle E,SMART Study Group.

doi

10.1016/j.ijcard.2012.05.034

subject

Has Abstract

pub_date

2013-09-01 00:00:00

pages

1929-35

issue

5

eissn

0167-5273

issn

1874-1754

pii

S0167-5273(12)00645-6

journal_volume

167

pub_type

杂志文章

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