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Published on: May 10, 2021
Linking soluble vascular adhesion molecule-1 level to calcific aortic stenosis in patients with coronary artery
Katerina Linhartova1, Gabriela Sterbakova, Jaroslav Racek
1Department of Cardiology, Cardiovascular Center, Motol University Hospital;
Insights
Elevated soluble vascular adhesion molecule-1 (s-VCAM-1) levels are linked to calcific aortic stenosis (AS) in patients with coronary artery disease (CAD). Lower soluble intercellular adhesion molecule-1 (s-ICAM-1) was also associated with AS.
Area of Science:
- Cardiovascular Medicine
- Immunology
- Atherosclerosis Research
Background:
- Calcific aortic stenosis (AS) is a prevalent valve disease linked to atherosclerosis, often necessitating surgical intervention.
- Understanding the role of inflammation in AS pathogenesis is crucial for developing targeted therapies.
Purpose of the Study:
- To investigate the association between specific inflammatory markers and the presence of AS in patients with advanced coronary artery disease (CAD).
- To identify potential biomarkers for calcific AS in the context of atherosclerosis.
Main Methods:
- Prospective study enrolling patients with CAD and AS (gradient ≥30 mmHg) and controls with aortic sclerosis (gradient ≤10 mmHg).
- Clinical evaluation, echocardiography, and coronary angiography were performed on all participants.
- Levels of soluble adhesion molecules (s-VCAM-1, s-ICAM-1, s-E-selectin) and C-reactive protein were measured.
Main Results:
- Patients with AS were older and exhibited significantly higher levels of s-VCAM-1 compared to controls.
- AS patients showed lower levels of s-ICAM-1 and s-E-selectin.
- C-reactive protein levels did not differ significantly between the groups.
- Elevated s-VCAM-1 and reduced s-ICAM-1 were independently associated with AS after adjusting for age.
Conclusions:
- Increased s-VCAM-1 levels are significantly associated with calcific aortic stenosis in patients with substantial coronary artery disease.
- Adhesion molecule profiles may serve as indicators for AS in atherosclerotic populations.
Background:
Calcific aortic stenosis (AS) is an atherosclerosis-related process and the most common cause of valve disease requiring surgery.
Objective:
To assess the association of inflammatory markers with AS in advanced atherosclerosis.
Methods:
Consecutive patients with coronary artery disease (CAD) associated with AS were prospectively identified (mean transvalvular aortic gradient of 30 mmHg or greater). Subjects with aortic sclerosis (mean transvalvular aortic gradient of 10 mmHg or less) served as controls. All patients underwent clinical evaluation, echocardiography and coronary angiography.
Results:
One hundred twenty-two patients with AS (85 men) and 101 with aortic sclerosis (76 men) of similar CAD severity were enrolled. The AS patients were older (mean [+/- SD] 71+/-7 years versus 66+/-7 years; P<0.001), had higher soluble vascular adhesion molecule-1 (s-VCAM-1) levels (1533+/-650 mug/L versus 1157+/-507 mug/L; P<0.001), but lower soluble intercellular adhesion molecule-1 (s-ICAM-1) (254+/-81 mug/L versus 293+/-84 mug/L; P<0.01) and soluble E-selectin (53+/-28 mug/L versus 62+/-29 mug/L; P<0.05) levels. The two groups did not differ with respect to C-reactive protein level (3+/-2.9 mg/L versus 3.4+/-2.6 mg/L; P not significant). Higher s-VCAM-1 (OR 1.09, 95% CI 1.04 to 1.14; P<0.001) and lower s-ICAM-1 (OR 0.82, 95% CI 0.72 to 0.94; P<0.001) levels were associated with AS after adjustment for age.
Conclusion:
Increased s-VCAM-1 levels were associated with calcific AS in patients with significant CAD.
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