Adhesion molecules and cardiovascular risk in peripheral arterial disease

Antonio Silvestro; Gregorio Brevetti; Vittorio Schiano; Francesco Scopacasa; Massimo Chiariello

doi:10.1160/TH04-07-0440

Thrombosis and Haemostasis, Table of Contents

Thromb Haemost 2005; 93(03): 559-563
DOI: 10.1160/TH04-07-0440

Wound Healing and Inflammation/Infection

Schattauer GmbH

Adhesion molecules and cardiovascular risk in peripheral arterial disease

Soluble vascular cell adhesion molecule-1 improves risk stratification

Antonio Silvestro^*

¹Department of Clinical Medicine and Cardiovascular and Immunological Sciences, University “Federico II”, Naples, Italy

,

Gregorio Brevetti^*

¹Department of Clinical Medicine and Cardiovascular and Immunological Sciences, University “Federico II”, Naples, Italy

,

Vittorio Schiano

¹Department of Clinical Medicine and Cardiovascular and Immunological Sciences, University “Federico II”, Naples, Italy

,

Francesco Scopacasa

²Department of Laboratory Medicine, University “Federico II”, Naples, Italy

,

Massimo Chiariello

¹Department of Clinical Medicine and Cardiovascular and Immunological Sciences, University “Federico II”, Naples, Italy

› Author Affiliations

Abstract

Summary

Although intercellular adhesion molecule-1 (ICAM-1) and vascular cell adhesion molecule-1 (VCAM-1) play a relevant role in atherosclerosis, little is known about the prognostic impact of their soluble forms (s) in patients with peripheral arterial disease (PAD). The aim of this prospective study was to verify whether plasma levels of s ICAM-1 and s VCAM-1 predict cardiovascular risk in PAD, and improve the prognostic value of the ankle/brachial index (ABI) alone. Accordingly, plasma levels of sICAM-1 and sVCAM-1, and the ABI were measured in 75 PAD patients who were monitored for a mean of 24±13 months. Twenty-two (29.3%) patients had a cardiovascular event (15 coronary, 3 cerebrovascular and 4 peripheral events). Plasma levels of sVCAM-1 were 618±258 ng/mL in patients with and 496±164 ng/mL in those without an event (p= 0.016). The corresponding sICAM-1 values were 344±239 ng/mL and 275±99 ng/mL (p= 0.079). The cardiovascular event rate was higher in patients with sVCAM-1 levels above the median than in those with sVCAM-1 below the median (p=0.0027 by log rank test). Independent predictors of events were sVCAM-1 levels above the median (p=0.005) and an ABI below the median (p= 0.001). Amongst patients with ABI below the median, the occurrence of sVCAM-1 above the median was associated with a 3.4-fold increase in risk (95% CI 1.308 to 9.573, p= 0.013). In conclusion, increased plasma levels of sVCAM-1 have a negative prognostic impact in PAD and improve the predictive value of ABI, which is currently the most powerful risk indicator in these patients.

Keywords

Peripheral arterial disease - adhesion molecules - cardiovascular diseases - prognosis - risk prediction

Full Text

References

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