Risk stratification in unstable angina and non-Q wave myocardial infarction using soluble cell adhesion molecules

Mulvihill, Niall; Foley, J.B.; Murphy, Ross T.; Curtin, Roland G.; Crean, Peter; Walsh, Michael J.

doi:10.1136/heart.85.6.623

Cited by 121 publications

(86 citation statements)

References 26 publications

(21 reference statements)

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“…Nevertheless, clincal data exists that elevated serum VCAM-1 can be observed in patients with arterial hypertension and the relation can be drawn between the serum concentration of VCAM-1 and the advancement of atherosclerosis [9]. The studies of Semaan and Mulvihill documented coronary artery disease coupled with elevated concentration of VCAM-1 [10,11]. Our analysis confirmed that VCAM-1 concentration is elevated in patients suffering from coronary artery disease.…”

Section: Discussionsupporting

confidence: 78%

Soluble Cell Adhesion Molecules – Does Estimating sVCAM-1 and sICAM-1 Concentration Provide Additional Information About Cardiovascular Risk in Patients with Coronary Artery Disease?

Hulok¹,

Ściborski²,

Marczak³

et al. 2014

Adv Clin Exp Med

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Objectives. Cell adhesion molecules (CAM) are thought to have a great impact on endothelium functioning. Interaction between CAM and a receptor may lead to macrophage activation and the release of multiple enzymes such as elastases and colagenases. These enzymes can, in turn, play a role in atherosclerotic plaque destabilization and initiation of acute coronary syndrome (ACS). The main aim of this study was to assess the role of sVCAM-1 and sICAM-1 in the risk stratification of ACS. Material and Methods. 63 patients -mean age 62.7 ± 9.5 years (26 women, 37 men) -were included in the study. Patients were divided into two groups: I -patients with acute coronary syndrome (ACS) diagnosed by coronary angiography (n = 45: 15 women; 30 men); and II -patients without apparent CAD in coronary angiography (n = 18: 11 women, 7 men). In both groups, samples required for sVCAM-1 and sICAM-1 level measurements were collected before the angiography. Results. Mean age, prevalence of arterial hypertension, diabetes mellitus and chronic kidney disease did not differ between the groups. Levels of sVCAM-1 and sICAM-1 were significantly higher in group I (group I vs. group II: 850.3 ± 337.9 vs. 675.9 ± 178.8; p = 0.02 and 737.2 ± 353.5 vs. 428.5 ± 157.3; p = 0.001 respectively). ROC analysis revealed that there is significantly higher risk of ACS above the level of 700.15 ng/mL for sVCAM-1 and 407.8 ng/mL for sICAM-1. The level of sVCAM-1 was also found to be an independent risk factor of NSTEMI, OR 1.003 (95% CI: 1.0007-1.004); p = 0.007, but not of STEMI (p > 0.05). Conclusions. Levels of sVCAM-1 and sICAM-1 were found to be negative predictors of acute coronary syndrome. Further studies should assess the relationship between sVCAM-1 and sICAM-1 levels and the survival of patients suffering from CAD (Adv Clin Exp Med 2014, 23, 5, 735-741).

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Section: Discussionsupporting

confidence: 78%

Soluble Cell Adhesion Molecules – Does Estimating sVCAM-1 and sICAM-1 Concentration Provide Additional Information About Cardiovascular Risk in Patients with Coronary Artery Disease?

Hulok¹,

Ściborski²,

Marczak³

et al. 2014

Adv Clin Exp Med

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“…Other putative mechanisms include activation of proinflammatory cytokines and proteins such as P-selectin and vascular cell adhesion molecule-1. 27 This upregulation may promote local tissue ischemia. In addition, bleeding, especially if severe, may lead to decreased circulating blood volume, anemia, and reduced oxygen delivery.…”

Section: Consequences Of Bleedingmentioning

confidence: 99%

The Challenge of Defining Bleeding Among Patients with Acute Coronary Syndromes

Wallace

Rao

2007

Clin Cardiol

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“…Fibrinogen was consistently found to be associated with long-term risk 42 ; however, the power of this association differs among studies, probably because of nonreproducible analytical methods or because of the consumption of fibrinogen during the acute phases. In addition, adhesion molecules and proinflammatory cytokines have been associated with a risk of new coronary events in ischemic heart diseases (ie, intracellular adhesion molecule-1 and soluble vascular adhesion molecule-1 43,44 and tumor necrosis factor-␣ 45 ) and with clinical recurrence of symptoms. 46 -48 Biological, economic, and analytical reasons, as reported before, partially explain their limitations.…”

Section: Other Inflammatory Markersmentioning

confidence: 99%

CDC/AHA Workshop on Markers of Inflammation and Cardiovascular Disease

Biasucci¹

2004

Circulation

153

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Abstract-Inflammation is a recognized key component of acute coronary syndromes. Such pathogenetic achievement has led to the use of inflammatory cells and proteins as prognostic markers in these syndromes. A number of markers have been proposed, including proinflammatory cytokines such as interleukin-6, interleukin-1RA, and tumor necrosis factor-␣, adhesion molecules such as intracellular adhesion molecule-1 and vascular adhesion molecule-1 and markers of cell activation. Although all are of scientific interest, the clinical use of these markers is limited by their high cost, low availability, and unfavorable biological profile. Conversely, common markers of inflammation such as C-reactive protein (CRP), the prototypic acute phase protein, and to a lesser extent fibrinogen, have been proven to be reliable and important markers of risk in ischemic heart disease. CRP, in particular, has been found to be associated with short-and long-term prognosis in acute coronary syndromes, including ST-elevation myocardial infarction, and in stable angina, and to predict the risk of restenosis and major events, including death, after revascularization procedures. CRP has been consistently found to be independent from other risk factors and to have an incremental value beyond the common risk factors and biochemical markers of risk, including troponin. Whether CRP also should be used as a guide to therapy is still a matter of discussion that deserves further, properly designed studies. Key Words: AHA Scientific Statements Ⅲ inflammation Ⅲ revascularization Ⅲ angina Ⅲ risk factors S hort-and long-term prediction of risk in patients with acute coronary syndromes (ACS) is a challenging clinical problem. Despite diagnostic and therapeutic advances, the rate of event recurrence is still relatively high (in the range of 14% to 16% at 6 months 1,2 ). The growing evidence that inflammation plays a pivotal role in the pathogenesis of most of the cases of ACS 3 led to the use of inflammatory mediators as markers of risk in these syndromes. 4 As consistent data have been accumulated in this area, risk prediction in ischemic heart disease and in ACS in particular represents the main use of inflammatory markers in cardiovascular medicine. More recently, sparse but intriguing data have been published suggesting that inflammatory markers may represent a marker of risk in other cardiovascular conditions. C-Reactive ProteinA number of inflammatory mediators have been studied as markers of risk in ischemic heart disease. They are discussed separately. Although many of them are of potential clinical interest (discussed below), C-reactive protein (CRP) is the inflammatory marker most extensively assessed in prognostic studies and is an almost perfect marker of inflammation (it has a half-life of 19 hours and is neither consumed nor produced during the reaction). This is the result, in part, of analytical reasons because of the availability of high-sensitivity, relatively low-cost methods for its measurement and in part because of its biological pr...

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Risk stratification in unstable angina and non-Q wave myocardial infarction using soluble cell adhesion molecules

Cited by 121 publications

References 26 publications

Soluble Cell Adhesion Molecules – Does Estimating sVCAM-1 and sICAM-1 Concentration Provide Additional Information About Cardiovascular Risk in Patients with Coronary Artery Disease?

Soluble Cell Adhesion Molecules – Does Estimating sVCAM-1 and sICAM-1 Concentration Provide Additional Information About Cardiovascular Risk in Patients with Coronary Artery Disease?

The Challenge of Defining Bleeding Among Patients with Acute Coronary Syndromes

CDC/AHA Workshop on Markers of Inflammation and Cardiovascular Disease

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