J A de Lemos1, C H Hennekens, P M Ridker. 1. Center for Cardiovascular Disease Prevention, Brigham and Women's Hospital, Boston, Massachusetts 02115, USA. jdelemos@rics.bwh.harvard.edu
Abstract
OBJECTIVES: The purpose of this study was to evaluate whether soluble vascular cell adhesion molecule-1 (sVCAM-1) is a marker for increased cardiovascular risk. BACKGROUND: Soluble forms of cellular adhesion molecules (CAMs) may be useful markers of endothelial activation and local or systemic inflammation. Recent studies indicate that plasma concentration of soluble intercellular adhesion molecule-1 (sICAM-1) is elevated many years before a first myocardial infarction (MI) occurs. However, only a few prospective studies have evaluated whether sVCAM-1 is also a marker for increased cardiovascular risk. METHODS: Baseline plasma samples were obtained prospectively from 14,916 healthy participants in the Physicians' Health Study. In a nested, case-control study design, the plasma concentration of sVCAM-1 was measured in 474 men with confirmed MI during the nine-year follow-up period, and in an equal number of control subjects who remained free of reported cardiovascular disease and who were matched for age, smoking status and length of follow-up. RESULTS: No significant difference in the median baseline sVCAM-1 concentration was found between case and control subjects (638 vs. 634 ng/ml; p = NS). Cardiovascular risk was similar between patients with sVCAM-1 levels in the highest quartile and those in the lowest quartile, in both crude (relative risk [RR] 1.28, 95% confidence interval [CI] 0.85 to 1.92) and adjusted (RR 1.17, 95% CI 0.71 to 1.91) matched-pairs analyses. CONCLUSIONS: In contrast to previous data on sICAM-1, we found no evidence of an association between sVCAM-1 levels and the risk of future MI in a large cohort of apparently healthy men. These data suggest important pathophysiologic differences between sVCAM-1 and sICAM-1 in the genesis of atherothrombosis.
OBJECTIVES: The purpose of this study was to evaluate whether soluble vascular cell adhesion molecule-1 (sVCAM-1) is a marker for increased cardiovascular risk. BACKGROUND: Soluble forms of cellular adhesion molecules (CAMs) may be useful markers of endothelial activation and local or systemic inflammation. Recent studies indicate that plasma concentration of soluble intercellular adhesion molecule-1 (sICAM-1) is elevated many years before a first myocardial infarction (MI) occurs. However, only a few prospective studies have evaluated whether sVCAM-1 is also a marker for increased cardiovascular risk. METHODS: Baseline plasma samples were obtained prospectively from 14,916 healthy participants in the Physicians' Health Study. In a nested, case-control study design, the plasma concentration of sVCAM-1 was measured in 474 men with confirmed MI during the nine-year follow-up period, and in an equal number of control subjects who remained free of reported cardiovascular disease and who were matched for age, smoking status and length of follow-up. RESULTS: No significant difference in the median baseline sVCAM-1 concentration was found between case and control subjects (638 vs. 634 ng/ml; p = NS). Cardiovascular risk was similar between patients with sVCAM-1 levels in the highest quartile and those in the lowest quartile, in both crude (relative risk [RR] 1.28, 95% confidence interval [CI] 0.85 to 1.92) and adjusted (RR 1.17, 95% CI 0.71 to 1.91) matched-pairs analyses. CONCLUSIONS: In contrast to previous data on sICAM-1, we found no evidence of an association between sVCAM-1 levels and the risk of future MI in a large cohort of apparently healthy men. These data suggest important pathophysiologic differences between sVCAM-1 and sICAM-1 in the genesis of atherothrombosis.
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