Circulating ICAM-1 and VCAM-1 in peripheral artery disease and hypercholesterolaemia: relationship to the location of atherosclerotic disease, smoking, and in the prediction of adverse events.
We examined the relationship of soluble intercellular adhesion molecule-1 (sICAM-1) and vascular cell adhesion molecule-1 (sVCAM-1) with smoking and hypercholesterolaemia in peripheral artery disease (PAD). Serum samples were obtained from 119 patients with objectively-proven PAD, 39 patients with hypercholesterolaemia but asymptomatic for PAD, and 132 age and sex matched asymptomatic controls. Using ELISAs, we found increased sICAM-1 and sVCAM-1 (both p <0.01) in the patients with PAD relative to the controls, but no significant change in patients with hypercholesterolaemia. However, the effect for sVCAM-1 was lost when smoking was entered as a covariate. Only sICAM-1 was higher in patients with PAD in the femoral/iliac arteries compared to the carotid arteries (p <0.05). In a 39-month follow-up of 112 patients with PAD, increased ICAM-1 weakly (univariate p <0.05) predicted those 57 whose disease progressed (i.e. to end points such as myocardial infarction and arterial surgery). However, high fibrinogen was a much better (univariate p = 0.001, multivariate p <0.05) predictor of disease progression. We suggest (i) that increased levels of sVCAM-1 in atherosclerosis are due to smoking, (ii) that increased sICAM-1 is independent of this risk factor, (iii) that both these changes are independent of hypercholesterolaemia, and (iv) that increased sICAM-1 is a weak predictor of disease progression in peripheral atherosclerosis.
Blann
A D
AD
Haemostasis, Thrombosis and Vascular Biology Unit, University Department of Medicine, The City Hospital, Birmingham, UK.
Seigneur
M
M
Steiner
M
M
Miller
J P
JP
McCollum
C N
CN
D000368:Aged; D001161:Arteriosclerosis / Q000097:blood* / Q000453:epidemiology / Q000473:pathology; D016893:Carotid Stenosis / Q000097:blood* / Q000453:epidemiology / Q000473:pathology; D015897:Comorbidity; D003430:Cross-Sectional Studies; D018450:Disease Progression; D005260:Female; D005263:Femoral Artery / Q000473:pathology*; D005340:Fibrinogen / Q000032:analysis; D005500:Follow-Up Studies; D006801:Humans; D006937:Hypercholesterolemia / Q000097:blood* / Q000453:epidemiology; D006973:Hypertension / Q000453:epidemiology; D018799:Intercellular Adhesion Molecule-1 / Q000097:blood*; D008297:Male; D008875:Middle Aged; D009928:Organ Specificity; D011897:Random Allocation; D012307:Risk Factors; D012907:Smoking / Q000097:blood / Q000453:epidemiology*; D019010:Vascular Cell Adhesion Molecule-1 / Q000097:blood*
D019010:Vascular Cell Adhesion Molecule-1; D018799:Intercellular Adhesion Molecule-1; D005340:Fibrinogen