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Circulating cell adhesion molecules and death in patients with coronary artery disease

S Blankenberg1, H J Rupprecht, C Bickel

  • 1Department of Medicine II, Johannes Gutenberg-University Mainz, Germany. stefan.blankenberg@uni-mainz.de

Circulation
|September 19, 2001
PubMed

Insights

Higher levels of soluble adhesion molecules, including vascular cell adhesion molecule-1 (sVCAM-1), predict future cardiovascular death in coronary artery disease (CAD) patients. Soluble VCAM-1 is a significant independent predictor of fatal cardiovascular events.

Area of Science:

  • Cardiovascular Medicine
  • Immunology
  • Biomarkers

Background:

  • Leukocyte adhesion molecules like VCAM-1, ICAM-1, and E-selectin contribute to atherosclerosis progression.
  • These molecules mediate leukocyte adhesion and transmigration, potentially driving plaque instability.

Purpose of the Study:

  • To investigate the association between soluble adhesion molecules and future cardiovascular events in patients with coronary artery disease (CAD).
  • To determine if soluble adhesion molecules improve risk prediction beyond established factors.

Main Methods:

  • Prospective cohort study of 1246 patients with angiographically documented CAD.
  • Baseline measurement of soluble VCAM-1 (sVCAM-1), sICAM-1, and sE-selectin.
  • Follow-up for cardiovascular events over a mean of 2.7 years.

Main Results:

  • Elevated sVCAM-1, sICAM-1, and sE-selectin levels were associated with increased cardiovascular death.
  • Patients in the highest quartile of sVCAM-1 had a 2.1-fold higher risk of fatal events.
  • sVCAM-1 remained an independent predictor of cardiovascular death, even after accounting for inflammation markers like hs-CRP.

Conclusions:

  • Soluble adhesion molecules, particularly sVCAM-1, are significantly linked to future cardiovascular mortality in CAD patients.
  • sVCAM-1 enhances the predictive value of traditional risk factors and hs-CRP for cardiovascular death.
Abstract

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