Linking soluble vascular adhesion molecule-1 level to calcific aortic stenosis in patients with coronary artery disease.
BACKGROUND
Calcific aortic stenosis (AS) is an atherosclerosis-related process and the most common cause of valve disease requiring surgery.


OBJECTIVE
To assess the association of inflammatory markers with AS in advanced atherosclerosis.


METHODS
Consecutive patients with coronary artery disease (CAD) associated with AS were prospectively identified (mean transvalvular aortic gradient of 30 mmHg or greater). Subjects with aortic sclerosis (mean transvalvular aortic gradient of 10 mmHg or less) served as controls. All patients underwent clinical evaluation, echocardiography and coronary angiography.


RESULTS
One hundred twenty-two patients with AS (85 men) and 101 with aortic sclerosis (76 men) of similar CAD severity were enrolled. The AS patients were older (mean [+/- SD] 71+/-7 years versus 66+/-7 years; P<0.001), had higher soluble vascular adhesion molecule-1 (s-VCAM-1) levels (1533+/-650 mug/L versus 1157+/-507 mug/L; P<0.001), but lower soluble intercellular adhesion molecule-1 (s-ICAM-1) (254+/-81 mug/L versus 293+/-84 mug/L; P<0.01) and soluble E-selectin (53+/-28 mug/L versus 62+/-29 mug/L; P<0.05) levels. The two groups did not differ with respect to C-reactive protein level (3+/-2.9 mg/L versus 3.4+/-2.6 mg/L; P not significant). Higher s-VCAM-1 (OR 1.09, 95% CI 1.04 to 1.14; P<0.001) and lower s-ICAM-1 (OR 0.82, 95% CI 0.72 to 0.94; P<0.001) levels were associated with AS after adjustment for age.


CONCLUSIONS
Increased s-VCAM-1 levels were associated with calcific AS in patients with significant CAD.
Linhartova
Katerina
K
Department of Cardiology, Cardiovascular Center, Motol University Hospital;
Sterbakova
Gabriela
G
Racek
Jaroslav
J
Cerbak
Roman
R
Porazikova
Karolina
K
Rokyta
Richard
R