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Aldosterone, atherosclerosis and vascular events in patients with stable coronary artery disease.
MedLine Citation:
PMID:  22727970     Owner:  NLM     Status:  Publisher    
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±10years, 82% male). During a median follow-up of 4.7years, 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 96pg/mL, interquartile range 70-138pg/mL, normal range 58-362pg/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.
Marieke A Hillaert; Eef G Lentjes; Hans Kemperman; Yolanda van der Graaf; Hendrik M Nathoe; Farzin Beygui; Gilles Montalescot; Pieter A Doevendans; Annemarie M Wassink; Eric van Belle;
Publication Detail:
Type:  JOURNAL ARTICLE     Date:  2012-6-22
Journal Detail:
Title:  International journal of cardiology     Volume:  -     ISSN:  1874-1754     ISO Abbreviation:  -     Publication Date:  2012 Jun 
Date Detail:
Created Date:  2012-6-25     Completed Date:  -     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  8200291     Medline TA:  Int J Cardiol     Country:  -    
Other Details:
Languages:  ENG     Pagination:  -     Citation Subset:  -    
Copyright Information:
Copyright © 2012 Elsevier Ireland Ltd. All rights reserved.
Department of Cardiology, University Medical Center Utrecht, Utrecht, The Netherlands.
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