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Circulating vascular cell adhesion molecule-1 correlates with the extent of human atherosclerosis in contrast to
K Peter1, P Nawroth, C Conradt
1Department of Cardiology, University of Heidelberg, Germany. kpeter@krzmail.krz.uni-heidelberg.de
Insights
Vascular cell adhesion molecule-1 (VCAM-1) in the blood may serve as a serum marker for detecting atherosclerosis. Higher VCAM-1 levels correlated significantly with the extent of atherosclerosis in patients with peripheral arterial disease.
Area of Science:
- Cardiovascular Medicine
- Biomarker Discovery
- Atherosclerosis Research
Background:
- Early detection of atherosclerosis is crucial for secondary prevention.
- Adhesion molecules, upregulated in plaques, are potential diagnostic markers.
- Existing markers lack correlation with atherosclerosis extent.
Purpose of the Study:
- To evaluate serum concentrations of adhesion molecules as potential biomarkers for atherosclerosis.
- To determine if VCAM-1 correlates with the extent of atherosclerosis.
- To assess VCAM-1's utility in indicating atherosclerosis stages.
Main Methods:
- Angiographic assessment of atherosclerosis extent in 52 patients with peripheral arterial disease.
- Measurement of serum levels of VCAM-1, ICAM-1, E-selectin, P-selectin, and thrombomodulin.
- Multivariate analysis to exclude confounding factors like age, diabetes, and hypertension.
Main Results:
- Serum VCAM-1 concentration showed a strong positive correlation with the extent of atherosclerosis (r = 0.8, P < .001).
- Other adhesion molecules (ICAM-1, E-selectin, P-selectin) and thrombomodulin did not correlate with atherosclerosis extent.
- VCAM-1 levels significantly indicated different stages of atherosclerosis.
Conclusions:
- VCAM-1 is a promising serum marker for detecting and staging atherosclerosis.
- VCAM-1 may play a significant role in the pathogenesis of atherosclerosis.
- Further research is warranted to validate VCAM-1 as a clinical diagnostic tool for atherosclerosis.
Abstract:
Secondary prevention of atherosclerosis, especially before the onset of symptoms, appears desirable and could be possible with a serum marker detecting atherosclerosis. Circulating, shedded forms of adhesion molecules may serve as such because their expression is upregulated in atherosclerotic plaques. In 52 patients with peripheral arterial vascular disease (Fontaine class IIa, 7 patients; class IIb, 29 patients; and class III, 16 patients), the extent of atherosclerosis was evaluated on the basis of angiograms of a large portion of the arterial system. The area diseased by atherosclerosis was determined by the percentage of vessel wall irregularities of the following calculated segments: aorta (distal from the kidney arteries), common iliac artery, external iliac artery, common femoral artery, lateral circumflex femoral artery, and popliteal artery. The maximal surface area that could exhibit atherosclerotic changes was 250 cm2. The serum concentration of circulating vascular cell adhesion molecule-1 (VCAM-1) correlated with the extent of atherosclerosis (r = .8, P < .001). In contrast, circulating intercellular adhesion molecule-1, E-selectin, P-selectin, and thrombomodulin (as markers for endothelial cell damage) did not correlate with the extent of atherosclerosis. Furthermore, circulating VCAM-1 could be used to indicate stages of atherosclerosis with a high degree of statistical significance. The potential bias of factors such as age, diabetes mellitus, hypercholesterolemia, arterial hypertension, renal failure, and history of myocardial infarction on the correlation of circulating VCAM-1 with the extent of atherosclerosis could be excluded by multivariate analysis. These findings suggest an important role of VCAM-1 in atherosclerosis and may serve as the basis for further evaluation of circulating VCAM-1 as a potential serum marker for atherosclerosis.