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Circulating soluble adhesion molecules ICAM-1 and VCAM-1 and incident coronary heart disease: the PRIME Study

Gérald Luc1, Dominique Arveiler, Alun Evans

  • 1Department of Atherosclerosis, SERLIA-INSERM UR325, Institut Pasteur de Lille, 1, rue du Professeur Calmette, 59019 Lille, France. gerald.luc@pasteur-lille.fr

Atherosclerosis
|September 6, 2003
PubMed

Insights

High levels of intercellular adhesion molecule-1 (ICAM-1) predict future heart attacks and coronary death. Combining ICAM-1 and C-reactive protein (CRP) measurements offers a more accurate coronary risk assessment than either marker alone.

Area of Science:

  • Cardiovascular Epidemiology
  • Biomarker Research
  • Preventive Cardiology

Background:

  • Cardiovascular diseases remain a leading cause of mortality worldwide.
  • Identifying reliable early risk markers for coronary events is crucial for prevention.
  • Adhesion molecules like ICAM-1 and VCAM-1 are implicated in atherosclerosis.

Purpose of the Study:

  • To investigate the association between plasma levels of soluble intercellular adhesion molecule-1 (ICAM-1) and vascular cell adhesion molecule-1 (VCAM-1) and the risk of future coronary events.
  • To determine if ICAM-1 and VCAM-1 can serve as independent risk markers for myocardial infarction and angina pectoris.
  • To explore the combined predictive value of ICAM-1 and C-reactive protein (CRP) for coronary risk.

Main Methods:

  • Prospective cohort study (Epidemiological Study of Myocardial Infarction Study) involving 9758 healthy men aged 50-59.
  • Nested case-control design analyzing plasma from 317 coronary event cases and 634 matched controls.
  • Measurement of plasma ICAM-1 and VCAM-1 levels at baseline using established laboratory techniques.

Main Results:

  • Elevated plasma ICAM-1 levels were significantly associated with an increased risk of myocardial infarction and coronary death (RR: 2.45 without adjustment, RR: 1.90 after CRP adjustment).
  • ICAM-1 also showed a significant association with the risk of angina pectoris.
  • No significant association was found between plasma VCAM-1 levels and the risk of future acute coronary events or angina pectoris.
  • Elevated coronary risk was observed only when both ICAM-1 and CRP levels were high, suggesting a synergistic effect.

Conclusions:

  • Plasma ICAM-1 levels are a significant risk marker for future coronary events, regardless of clinical presentation.
  • VCAM-1 is not associated with an increased risk of acute coronary events or angina.
  • Simultaneous measurement of ICAM-1 and CRP provides a more robust assessment of coronary risk compared to individual markers.

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