title: Soluble endothelial cell selective adhesion molecule and cardiovascular outcomes in patients with stable coronary disease: A report from the Heart and Soul Study.
abstract: OBJECTIVE
  Endothelial cell-selective adhesion molecule (ESAM) is selectively expressed on vascular endothelium and is postulated to play a role in atherogenesis. We investigated the association of serum soluble ESAM (sESAM) levels with subsequent cardiovascular outcomes in patients with stable ischemic heart disease.
  
  
  METHODS
  We measured sESAM levels in 981 patients with stable coronary disease enrolled between September 2000 and December 2002 in a prospective cohort study. Poisson regression models were used to define the relationship between baseline sESAM levels and cardiovascular outcomes, including myocardial infarction, heart failure hospitalization, and mortality.
  
  
  RESULTS
  There were 293 occurrences of the composite endpoint over a median follow-up of 8.9 years. After adjusting for demographic and clinical risk factors, participants in the highest sESAM quartile (compared to the lower three sESAM quartiles) had a higher rate of the composite endpoint (incident rate ratio (IRR) 1.52 (95% CI 1.16-1.99) as well as of its individual components: myocardial infarction (IRR 1.64 (1.06-2.55)), heart failure hospitalizations (IRR 1.96 (1.32-2.81)), and death (IRR 1.5 (1.2-1.89)). These associations were no longer significant after adjustment for estimated glomerular filtration rate.
  
  
  CONCLUSIONS
  sESAM levels associate with myocardial infarction, heart failure, and death after adjustment for demographic and clinical risk factors, but not after adjustment for kidney function. sESAM may be involved in the pathogenesis of concurrent kidney and cardiovascular disease.
authors.affiliation: Division of Nephrology, University of California, San Francisco (UCSF), San Francisco, CA, USA. Electronic address: meyeon.park@ucsf.edu.
authors.forename: Meyeon
authors.initials: M
authors.lastname: Park
authors.affiliation: Kaiser Permanente, McLean, VA, USA.
authors.forename: Ameya
authors.initials: A
authors.lastname: Kulkarni
authors.affiliation: Division of Cardiology, VA Puget Sound Health Care System, University of Washington, USA.
authors.forename: Alexis
authors.initials: A
authors.lastname: Beatty
authors.affiliation: Division of Cardiology, VA Puget Sound Health Care System, University of Washington, USA; Division of Cardiology, University of California San Francisco and San Francisco General Hospital, USA.
authors.forename: Peter
authors.initials: P
authors.lastname: Ganz
authors.affiliation: Department of Medicine, San Francisco VA Hospital, San Francisco, CA, USA.
authors.forename: Mathilda
authors.initials: M
authors.lastname: Regan
authors.affiliation: Department of Epidemiology and Biostatistics, UCSF, San Francisco, CA, USA.
authors.forename: Eric
authors.initials: E
authors.lastname: Vittinghoff
authors.affiliation: Department of Medicine, San Francisco VA Hospital, San Francisco, CA, USA; Department of Medicine, UCSF, San Francisco, CA, USA; Department of Epidemiology and Biostatistics, UCSF, San Francisco, CA, USA.
authors.forename: Mary
authors.initials: M
authors.lastname: Whooley
mesh_terms: D000328:Adult; D000368:Aged; D015415:Biomarkers / Q000097:blood; D015815:Cell Adhesion Molecules / Q000097:blood*; D016009:Chi-Square Distribution; D003324:Coronary Artery Disease / Q000097:blood* / Q000175:diagnosis / Q000401:mortality / Q000628:therapy; D018450:Disease Progression; D005260:Female; D005919:Glomerular Filtration Rate; D006333:Heart Failure / Q000097:blood / Q000401:mortality / Q000628:therapy; D006760:Hospitalization; D006801:Humans; D015994:Incidence; D007668:Kidney / Q000503:physiopathology; D008297:Male; D008875:Middle Aged; D015999:Multivariate Analysis; D009203:Myocardial Infarction / Q000097:blood / Q000401:mortality; D016017:Odds Ratio; D011379:Prognosis; D011446:Prospective Studies; D018570:Risk Assessment; D012307:Risk Factors; D012495:San Francisco / Q000453:epidemiology; D013997:Time Factors; D015854:Up-Regulation
chemical_list: D015415:Biomarkers; D015815:Cell Adhesion Molecules; C568779:ESAM protein, human
keywords: Atherosclerosis; Cardiovascular mortality; Endothelium; Kidney disease