Adhesion molecules and C-reactive protein are associated to adverse events in angina pectoris.
OBJECTIVE
To examine the prognostic value of soluble cellular adhesion molecules (CAMs) and highly sensitive C reactive protein (hsCRP) on long-term outcome for patients with stable angina pectoris (SAP).


METHODS
In a prospective study, 291 patients referred for coronary angiography due to clinically suspected SAP had serum level of soluble intercellular adhesion molecule-1 (sICAM-1), vascular adhesion molecule-1 (sVCAM-1), sP-selectin and hsCRP determined at baseline. The primary outcome was predefined as death from any cause, myocardial infarction or stroke during a mean follow-up of 7.1 years.


RESULTS
Thirty four patients experienced the primary outcome. Hazard ratios and 95% confidence intervals for the primary outcome were: sVCAM-1: 2.4 [1.1-4.9], sICAM-1: 3.3 [1.5-7.2], sP-selectin: 1.2 [0.6-2.6] and hs-CRP: 3.1 [1.5-6.3], when comparing patients in the 4th quartile with those in lower quartiles in a multivariable model. Higher risk of adverse outcome was observed in patients having levels of both hsCRP and sICAM-1 (HR 4.7 [1.7-9.9]) or hsCRP and sVCAM-1 (HR 4.2 [1.7-9.9]) in the 4th quartile.


CONCLUSIONS
sVCAM-1, sICAM-1 and hsCRP were significantly associated with long term outcomes of patients with SAP beyond the risk associated with traditional risk factors. Risk predictions were improved when combining information about sCAMs and hsCRP.
Eschen
Ole
O
Department of Cardiology, Center for Cardiovascular Research, Aalborg Sygehus, Aarhus University Hospital, Aalborg, Denmark. oe@dadlnet.dk
Christensen
Jeppe Hagstrup
JH
Johnsen
Søren Paaske
SP
Dethlefsen
Claus
C
Schmidt
Erik Berg
EB
D000368:Aged; D000787:Angina Pectoris / Q000000981:diagnostic imaging / Q000276:immunology* / Q000401:mortality / Q000628:therapy; D015415:Biomarkers / Q000097:blood; D002097:C-Reactive Protein / Q000378:metabolism*; D015815:Cell Adhesion Molecules / Q000097:blood*; D016009:Chi-Square Distribution; D017023:Coronary Angiography; D003324:Coronary Artery Disease / Q000000981:diagnostic imaging / Q000276:immunology* / Q000401:mortality / Q000628:therapy; D005260:Female; D005500:Follow-Up Studies; D006760:Hospitalization; D006801:Humans; D018799:Intercellular Adhesion Molecule-1 / Q000097:blood; D053208:Kaplan-Meier Estimate; D008297:Male; D008875:Middle Aged; D009203:Myocardial Infarction / Q000276:immunology; D019007:P-Selectin / Q000097:blood; D011379:Prognosis; D016016:Proportional Hazards Models; D011446:Prospective Studies; D018570:Risk Assessment; D012307:Risk Factors; D020521:Stroke / Q000276:immunology; D013997:Time Factors; D019010:Vascular Cell Adhesion Molecule-1 / Q000097:blood
D015415:Biomarkers; D015815:Cell Adhesion Molecules; D019007:P-Selectin; D019010:Vascular Cell Adhesion Molecule-1; D018799:Intercellular Adhesion Molecule-1; D002097:C-Reactive Protein