Serum VCAM-1 and ICAM-1 measurement assists for MACE risk estimation in ST-segment elevation myocardial infarction
Jiancai Yu1,2, Yongxing Liu1, Wanzhong Peng1
1Tianjin Medical University, Tianjin, China.
Insights
Vascular cell adhesion molecule-1 (VCAM-1) and intercellular adhesion molecule-1 (ICAM-1) predict major adverse cardiac events (MACE) in ST-segment elevation myocardial infarction (STEMI) patients. Combining VCAM-1 with other factors improves MACE risk prediction accuracy.
Area of Science:
- Cardiology
- Biomarkers
- Atherosclerosis Research
Background:
- Vascular cell adhesion molecule-1 (VCAM-1) and intercellular adhesion molecule-1 (ICAM-1) are implicated in atherosclerosis.
- These molecules may contribute to major adverse cardiac events (MACE) by promoting leukocyte infiltration and endothelial cell proliferation.
Purpose of the Study:
- To evaluate the predictive value of VCAM-1 and ICAM-1 for MACE in patients with ST-segment elevation myocardial infarction (STEMI).
Main Methods:
- Serum VCAM-1 and ICAM-1 levels were measured using ELISA in 373 STEMI patients and 50 healthy controls (HCs).
- MACE occurrence was monitored during a median follow-up of 18 months.
Main Results:
- STEMI patients exhibited significantly higher VCAM-1 and ICAM-1 levels compared to HCs (p < 0.001).
- Elevated VCAM-1 and ICAM-1 levels were associated with an increased MACE rate in STEMI patients.
- VCAM-1, age ≥ 65 years, diabetes mellitus, C-reactive protein ≥ 5 mg/L, and multivessel disease independently predicted MACE risk.
Conclusions:
- VCAM-1 and ICAM-1 measurements are valuable for predicting MACE risk in STEMI patients.
- A nomogram incorporating VCAM-1 and traditional prognostic factors demonstrated acceptable accuracy for predicting 1, 2, and 3-year MACE risk.
Background:
Vascular cell adhesion molecule-1 (VCAM-1) and intercellular adhesion molecule-1 (ICAM-1) modulate atherosclerosis by promoting leukocyte infiltration, neutrophil recruitment, endothelial cell proliferation, etc., which may directly or indirectly facilitate the occurrence of major adverse cardiac events (MACE). This study intended to investigate the value of VCAM-1 and ICAM-1 for predicting MACE in ST-segment elevation myocardial infarction (STEMI) patients.
Methods:
Totally, 373 STEMI patients receiving the percutaneous coronary intervention and 50 health controls (HCs) were included. Serum VCAM-1 and ICAM-1 were detected by ELISA. Meanwhile, MACE was recorded during a median follow-up of 18 (range: 1-46) months in STEMI patients.
Results:
Vascular cell adhesion molecule-1 and ICAM-1 were raised in STEMI patients compared with HCs (both p < 0.001). VCAM-1 (p = 0.002) and ICAM-1 (p = 0.012) high were linked with raised accumulating MACE rate in STEMI patients. Notably, VCAM-1 high (hazard ratio [HR] = 2.339, p = 0.031), age ≥ 65 years (HR = 2.019, p = 0.039), history of diabetes mellitus (DM) (HR = 2.395, p = 0.011), C-reactive protein (CRP) ≥ 5 mg/L (HR = 2.550, p = 0.012), multivessel disease (HR = 2.561, p = 0.007) independently predicted MACE risk in STEMI patients. Furthermore, a nomogram-based prediction model combining these factors was established, exhibiting an acceptable value for estimating 1, 2, and 3-year MACE risk, with AUC of 0.764, 0.716, and 0.778, respectively, in STEMI patients.
Conclusion:
This study confirms the value of VCAM-1 and ICAM-1 measurement in predicting MACE risk in STEMI patients. Moreover, VCAM-1 plus other traditional prognostic factors (such as age, history of DM, CRP, and multivessel disease) cloud further improve the predictive accuracy of MACE risk in STEMI patients.
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