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sFAS identified as atherosclerosis risk factor

(Vienna, 22-7-2011) Marker protein found for cell apoptosis: high concentrations in the blood present a risk for acute cardiovascular events.

Vessel calcification, or atherosclerosis, is principally a symptom of old age. The plaques in the arteries develop over the decades, until they cause acute events by cardiac infarction or stroke. It would be momentous if we were able to identify those persons at risk at an early stage. Scientists of the MedUni Vienna have found a possible new ‘marker’ for this: a protein which appears in the blood when there are elevated “cell suicide rates”. The team from the Departments of Angiology and Cardiology of the University Department of Internal Medicine II (General Hospital), which published their work a few days ago in the internationally renowned specialist journal Stroke, explains that “the markers for apoptosis (“programmed cell death” with preceding severe damage, editor’s explanatory note) are closely associated with cardiovascular diseases.

The soluble apoptosis-stimulating protein fragment (sFAS) had already been identified as a prognosis factor for patients with chronic cardiac insufficiency; however its significance for patients with atherosclerosis had not yet completely been explained.” As a result the first author Matthias Hoke and the co-authors examined the concentrations of sFAS in the blood of 981 patients with asymptomatic atherosclerotic changes of the carotid arteries (a significant risk factor for heart attacks and also an easily determinable indication for the presence of atherosclerosis found in an ultrasound). The observation time was 6.2 years on average.

Co-Author Alexander Niessner from the Clinical Department of Cardiology at the Vienna University Department: “The patients had previous symptom-free atherosclerosis. It was proven in the study that each person, who belonged in the 20 percent group of subjects with the highest sFAS values in the blood, showed around a 2.3-fold increased overall mortality and around a 2.4-fold increased mortality rate from cardiovascular disease.” The result was highly significant statistically as there were in total 250 deaths (25.5 percent), of which 165 were recorded as cardiovascular deaths (66 percent).

Niessner says, “Up until now we have primarily seen the inflammatory marker C-reactive protein as a prognosis factor. Through combination with sFAS, however, we could evidently markedly increase the information available to aid prognosis.” Such risk assessments are therefore so very important because they could be a criterion for possible increased preventative measures. Atherosclerosis is a general problem from a certain age, however it does not result in cardiac infarction, stroke etc. in every case.

Publication in Stroke:
» The Prognostic Impact of Soluble Apoptosis-Stimulating Fragment on Mortality in Patients With Carotid Atherosclerosis. Matthias Hoke, MD; Martin Schillinger, MD; Gerlinde Zorn; Anna Wonnerth, MD; Jasmin Amighi, MD; Wolfgang Mlekusch, MD; Walter Speidl, MD; Gerald Maurer, MD; Renate Koppensteiner, MD; Erich Minar, MD; Johann Wojta, PhD; Alexander Niessner, MD, MSc.

About the authors
Univ. lecturer Dr. Med. Matthias Hoke, 31, and private lecturer, Ass. Prof. Dr. Med. Alexander Niessner, 39, work at Medical University of Vienna’s University Department of Internal Medicine II. Niessner starting studying medicine at the University of Vienna in 1992, which was interrupted by a one-year study visit to Spain in the context of an ERASMUS grant.

Since receiving his doctorate in 1998 Niessner has been working at the University Department of Internal Medicine II, Department of Cardiology, in the research group “Atherosclerosis, thrombosis and vascular biology” and studied the connection between atherosclerosis and inflammation.

Niessner has also been received several grants and awards: Erasmus EU grant, Schrödinger Mobility Grant from the FWF; Basic Research Award of the Austrian Society of Cardiology 2006; Seymour and Vivian Milstein Young Investigator Award (International Society for Interferon and Cytokine Research) 2006; Researcher of the Month of the MedUni Vienna March 2008 and the Otto Kraupp Prize for the best post-doctorate work.

Matthias Hoke from Klagenfurt studied at the Medical University of Vienna from 1997 – 2003. He studies, amongst others, the subject areas of atherosclerosis in the carotid arteries, risk factors of venous thromboembolism, genetic risks and epidemiology for cardiovascular diseases. His awards include the 2003 Scholarship (“a special fund from the University of Vienna”), 2010 Best Poster at the Three-Country Angiology Conference in Basel, 1st place und 2011 Best Abstract