Increased levels of markers of vascular inflammation in patients with coronary heart disease

Abstract

Elevated levels of soluble cell adhesion molecules (sCAMs), inflammatory cytokines and C-reactive protein (CRP) have been associated with atherosclerotic disease states. The aim of the present study was to evaluate whether circulating levels of vascular cell adhesion molecule-1 (sVCAM-1), intercellular adhesion molecule-1 (sICAM-1), E- and P-selectin were significantly elevated in patients with coronary heart disease (CHD) compared with healthy controls, and to study possible associations between these sCAMs, tumour necrosis factor alpha (TNFalpha). interleukin-6 (IL-6), CRP and major CHD risk factors. The study included 193 patients in various stages of CHD and 193 matched controls. To evaluate any possible influence of acute phase reaction, reinvestigation was performed after 6 months. After adjustment for major CHD risk factors, sVCAM-1, sICAM-1, P-selectin, IL-6 and CRP remained significantly elevated in the CHD patients (p for all <0.001). In multivariate analysis sVCAM-1 was predicted by age (p=0.015), sICAM-1 by smoking (p<0.001) and total cholesterol (p=0.026), E-selectin by body mass index (BMI) (p=0.004) and P-selectin by male gender (p=0.015). TNFalpha significantly predicted sICAM-1 and E-selectin levels, while IL-6 predicted CRP but none of the sCAMs measured. This might indicate that TNFalpha, but not IL-6, plays a major role in the regulation of sCAM levels in vivo.

Do novel risk factors differ between men and women aged 18 to 39 years with a high risk of coronary heart disease?

“…Several risk factors (ICAM-1, E selectin) were related to cigarette smoking, in agreement with previous studies [28,29]. We have previously reported that smoking cessation reduced levels of ICAM-1 in a subset of this cohort [22], suggesting a causal relation between smoking and ICAM-1 metabolism.…”

“…Previous studies comparing men and women have largely been conducted in older or diseased individuals [11,26,28,29], although sex differences have been better studied in regard to the more established hemostatic parameters [30]. The prevalence of smoking among the women in our study was surprisingly high, most likely because of their being selected from high-risk families and the prerequisite of dyslipidemia for participation in the study.…”

Increased levels of C‐reactive protein and interleukin‐6 in hyperhomocysteinemic subjects

“…Interleukin (IL)-6, a cytokine known to be secreted from a number of cells including macrophages, lymphocytes and endothelial cells, has been shown to be a major regulator of CRP synthesis and may thus have a key role in initiation of the acute-phase response in various inflammatory conditions such as CVD [11]. In fact, increased levels of IL-6 have been shown to be associated with increased frequency of coronary artery disease (CAD) in men [12], increased risk of myocardial infarction in apparently healthy individuals [13] and to be elevated in patients with CAD compared to healthy controls [14].…”

n-3 Fatty acids and cardiovascular disease: Actions and molecular mechanisms

“…Soluble forms of these molecules (sCAMs) are thought to reflect the amount of molecules expressed on the endothelial surface [54]. Patients with manifest or future CVD have an elevated serum concentration of these inflammatory markers [55,56]. EPA and DHA supplementation in human studies decrease sCAMs [48,49] and pro-inflammatory cytokines IL-1β, IL-6 and TNFα [50].…”