title: Value of serum-soluble intercellular adhesion molecule-1 for the noninvasive risk assessment of transplant coronary artery disease, posttransplant ischemic events, and cardiac graft failure.
abstract: BACKGROUND
  Adhesion molecules on arterial endothelium have been implicated in spontaneous atherosclerosis and transplant coronary artery disease (CAD). We studied whether elevated serum-soluble intercellular adhesion molecule-1 (sICAM-1) during the immediate posttransplant period was a risk factor for CAD, posttransplant ischemic events, or cardiac graft failure.
  
  
  RESULTS
  We initially studied serum sICAM-1 in a subset of 16 cardiac allograft recipients (5.5+/-0.7 samples per patient) to determine a cutoff point that best correlated with presence of arterial and arteriolar endothelial ICAM-1 in matching endomyocardial biopsies. The cutoff value was 308 ng/mL. Subsequently, we prospectively evaluated serum sICAM-1 in serial samples (5.3+/-0.1 per patient) obtained during the first 3 months after transplantation in a validation subset of 130 recipients and correlated early sICAM-1 levels with long-term outcome. Serum sICAM-1 >308 ng/mL correlated significantly with ICAM-1 on arterial and arteriolar endothelium (P:=0.02). Cardiac allograft recipients with serum sICAM-1 >308 ng/mL had 2.67 (95% CI, 1.28 to 5.59, P:=0.009) times greater risk of CAD and 3.63 (95% CI, 1.05 to 12.5, P:=0.04) times greater risk of graft failure. Recipients with sICAM-1 >308 ng/mL also developed more severe CAD (P:=0.009) and more ischemic events (P:=0.03) after transplantation.
  
  
  CONCLUSIONS
  Serum sICAM-1 levels can be used to noninvasively assess risk of transplant CAD, posttransplant ischemic events, and cardiac graft failure.
authors.affiliation: Methodist Research Institute, Clarian Health Partners (Methodist, Indiana University, Riley Hospitals), Indianapolis, IN, USA.
authors.forename: C A
authors.initials: CA
authors.lastname: Labarrere
authors.forename: D R
authors.initials: DR
authors.lastname: Nelson
authors.forename: S J
authors.initials: SJ
authors.lastname: Miller
authors.forename: J M
authors.initials: JM
authors.lastname: Nieto
authors.forename: J A
authors.initials: JA
authors.lastname: Conner
authors.forename: D E
authors.initials: DE
authors.lastname: Pitts
authors.forename: P C
authors.initials: PC
authors.lastname: Kirlin
authors.forename: H G
authors.initials: HG
authors.lastname: Halbrook
mesh_terms: D001026:Coronary Artery Bypass / Q000009:adverse effects*; D003327:Coronary Disease / Q000097:blood* / Q000209:etiology / Q000473:pathology*; D004730:Endothelium, Vascular / Q000473:pathology*; D006084:Graft Rejection / Q000097:blood* / Q000209:etiology / Q000473:pathology*; D006801:Humans; D018799:Intercellular Adhesion Molecule-1 / Q000097:blood*; D017202:Myocardial Ischemia / Q000473:pathology*; D009206:Myocardium / Q000473:pathology; D011446:Prospective Studies; D013997:Time Factors
chemical_list: D018799:Intercellular Adhesion Molecule-1