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Coronary Progenitor Cells and Soluble Biomarkers in Cardiovascular Prognosis after Coronary Angioplasty
Published on: January 28, 2020
Associations between C-reactive protein and circulating cell adhesion molecules in patients with unstable angina
Young-Cheoul Doo1, Sang-Jin Han, Woo-Jung Park
1Division of Cardiology, Department of Internal Medicine, Kang-Dong Sacred Heart Hospital, College of Medicine, Hallym University, Seoul, Korea. ycdoo97@yahoo.co.kr
Insights
C-reactive protein (CRP) and intercellular adhesion molecule-1 (ICAM-1) predict cardiac events in unstable angina patients post-stenting. Elevated CRP and ICAM-1 levels indicate higher risk, suggesting CRP
Area of Science:
- Cardiology
- Inflammation Research
- Atherosclerosis Studies
Background:
- Growing evidence suggests C-reactive protein (CRP) plays a direct role in atherosclerosis.
- Inflammatory markers are increasingly recognized as significant in cardiovascular disease pathogenesis.
Purpose of the Study:
- To assess associations between CRP and adhesion molecules.
- To determine the prognostic value of adhesion molecules in predicting cardiac events.
- To evaluate these markers in patients with unstable angina undergoing coronary stenting.
Main Methods:
- Study included 55 unstable angina patients (Braunwald class IIb or IIIb) undergoing coronary stenting.
- Measured CRP and intercellular adhesion molecule-1 (ICAM-1) levels.
- Utilized multiple linear regression analysis and assessed prognostic value for cardiac events.
Main Results:
- A significant trend showed increasing ICAM-1 concentrations with higher CRP levels at 72 hours post-stenting (p=0.03).
- CRP levels were the sole determinant of ICAM-1 concentrations at 72 hours.
- Elevated CRP (>5.4 mg/l) and ICAM-1 (>321 ng/ml) independently predicted adverse cardiac events (p<0.05).
Conclusions:
- CRP and ICAM-1 measurements are valuable for risk stratification in unstable angina patients post-stenting.
- CRP may directly contribute to atherosclerosis by inducing ICAM-1 expression.
- These inflammatory markers identify patients at higher risk for cardiac events.
Background:
There is growing evidence that C-reactive protein (CRP) may have a direct role in the pathogenesis of atherosclerosis.
Hypothesis:
The purpose of this study was to assess associations between CRP and adhesion molecules and to determine the prognostic value of adhesion molecules as a predictor of cardiac events in patients with unstable angina.
Methods:
Fifty-five consecutive patients (33 males, mean age 61 years) with unstable angina (Braunwald class IIb or IIIb) undergoing coronary stenting were included in this study.
Results:
The test for a trend toward increasing intercellular adhesion molecule (ICAM)-1 concentrations by the 75th percentile of CRP levels at 72 h after coronary stenting was significant (p = 0.03). At 72 h after coronary stenting, CRP levels were the only determinants of ICAM-1 concentrations by multiple linear regression analysis. An elevated level of CRP (>5.4 mg/l) (odds ratio [OR] 1.5, 95% confidence interval [CI] 1.3-3.7, p < 0.05) and ICAM-1 (>321 ng/ml) (OR 1.2, 95% CI 1.1-2.1, p < 0.05) at 72 h after coronary stenting is an independent risk factor for an adverse cardiac event.
Conclusions:
These results suggest that in patients with unstable angina undergoing coronary stenting, the measurements of inflammatory parameters, especially CRP and ICAM-1, may be useful for identifying those at higher risk of a cardiac event, and CRP may play a direct role in promoting the inflammatory component of atherosclerosis by inducing significant expression of ICAM-1.
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