OBJECTIVE: To assess prospectively the prognostic value of soluble cellular adhesion molecules (CAMs) in patients with unstable angina and non-Q wave myocardial infarction and to compare their prognostic accuracy with that of C reactive protein (CRP). DESIGN AND SETTING: Prospective observational study of patients presenting acutely with unstable angina and non-Q wave myocardial infarction to a single south Dublin hospital. METHODS: Patients with Braunwald IIIA unstable angina and non-Q wave myocardial infarction had serum samples taken at presentation before initiation of antithrombotic treatment and were followed for six months. The primary end point was the occurrence of major adverse cardiovascular events (recurrent unstable angina, non-fatal myocardial infarction, and cardiovascular death) at six months. Concentrations of soluble intercellular adhesion molecule-1 (sICAM-1), soluble vascular cell adhesion molecule-1 (sVCAM-1), soluble endothelial selectin, and soluble platelet selectin were measured using an enzyme linked immunosorbent assay technique. CRP was measured with an immunophelometric assay. RESULTS: 91 patients (73 men and 18 women, mean (SD) age 61 (11) years) were studied; 27 patients (30%) had major adverse cardiac events during the six months of follow up. Concentration of CRP were significantly raised in patients who had an ischaemic event (mean (SEM) 11.5 (6.4) mg/l v 5.4 (2.5) mg/l, p < 0.001). Concentrations of sVCAM-1 were also significantly raised in the ischaemic event group (979 (30) ng/ml v 729 (22) ng/ml, p < 0.001). Both sVCAM-1 and CRP concentrations correlated strongly with the occurrence of an adverse event. The sensitivity of CRP > 3 mg/l and sVCAM-1 > 780 ng/ml for predicting future events was > 90%. There was no difference in concentrations of sICAM-1, soluble endothelin selectin, or soluble platelet selectin between event and non-event groups. CONCLUSION: Raised concentrations of sVCAM-1 and CRP are predictive of an increased risk of major adverse cardiovascular events six months after presentation with unstable angina and non-Q wave myocardial infarction. These findings suggest that the intensity of the vascular inflammatory process at the time of presentation is a determinant of clinical outcome in unstable coronary artery disease.
OBJECTIVE: To assess prospectively the prognostic value of soluble cellular adhesion molecules (CAMs) in patients with unstable angina and non-Q wave myocardial infarction and to compare their prognostic accuracy with that of C reactive protein (CRP). DESIGN AND SETTING: Prospective observational study of patients presenting acutely with unstable angina and non-Q wave myocardial infarction to a single south Dublin hospital. METHODS:Patients with Braunwald IIIA unstable angina and non-Q wave myocardial infarction had serum samples taken at presentation before initiation of antithrombotic treatment and were followed for six months. The primary end point was the occurrence of major adverse cardiovascular events (recurrent unstable angina, non-fatal myocardial infarction, and cardiovascular death) at six months. Concentrations of soluble intercellular adhesion molecule-1 (sICAM-1), soluble vascular cell adhesion molecule-1 (sVCAM-1), soluble endothelial selectin, and soluble platelet selectin were measured using an enzyme linked immunosorbent assay technique. CRP was measured with an immunophelometric assay. RESULTS: 91 patients (73 men and 18 women, mean (SD) age 61 (11) years) were studied; 27 patients (30%) had major adverse cardiac events during the six months of follow up. Concentration of CRP were significantly raised in patients who had an ischaemic event (mean (SEM) 11.5 (6.4) mg/l v 5.4 (2.5) mg/l, p < 0.001). Concentrations of sVCAM-1 were also significantly raised in the ischaemic event group (979 (30) ng/ml v 729 (22) ng/ml, p < 0.001). Both sVCAM-1 and CRP concentrations correlated strongly with the occurrence of an adverse event. The sensitivity of CRP > 3 mg/l and sVCAM-1 > 780 ng/ml for predicting future events was > 90%. There was no difference in concentrations of sICAM-1, soluble endothelin selectin, or soluble platelet selectin between event and non-event groups. CONCLUSION: Raised concentrations of sVCAM-1 and CRP are predictive of an increased risk of major adverse cardiovascular events six months after presentation with unstable angina and non-Q wave myocardial infarction. These findings suggest that the intensity of the vascular inflammatory process at the time of presentation is a determinant of clinical outcome in unstable coronary artery disease.
Authors: W H Haught; M Mansour; R Rothlein; T K Kishimoto; E A Mainolfi; J B Hendricks; C Hendricks; J L Mehta Journal: Am Heart J Date: 1996-07 Impact factor: 4.749
Authors: G Liuzzo; L M Biasucci; J R Gallimore; R L Grillo; A G Rebuzzi; M B Pepys; A Maseri Journal: N Engl J Med Date: 1994-08-18 Impact factor: 91.245
Authors: Fen Wu; Farzana Jasmine; Muhammad G Kibriya; Mengling Liu; Oktawia Wójcik; Faruque Parvez; Ronald Rahaman; Shantanu Roy; Rachelle Paul-Brutus; Stephanie Segers; Vesna Slavkovich; Tariqul Islam; Diane Levy; Jacob L Mey; Alexander van Geen; Joseph H Graziano; Habibul Ahsan; Yu Chen Journal: Am J Epidemiol Date: 2012-04-24 Impact factor: 4.897
Authors: Kara S Hughan; Hala Tfayli; Julia G Warren-Ulanch; Emma Barinas-Mitchell; Silva A Arslanian Journal: J Pediatr Date: 2015-11-03 Impact factor: 4.406
Authors: Louis T van Zyl; Francois Lespérance; Nancy Frasure-Smith; Alex I Malinin; Dan Atar; Marc-André Laliberté; Victor L Serebruany Journal: J Thromb Thrombolysis Date: 2008-01-11 Impact factor: 2.300
Authors: Ahmad Hayek; Alexandre Paccalet; Laura Mechtouff; Claire C Da Silva; Fabrice Ivanes; Hadrien Falque; Simon Leboube; Yvonne Varillon; Camille Amaz; Charles de Bourguignon; Cyril Prieur; Danka Tomasevic; Nathalie Genot; François Derimay; Eric Bonnefoy-Cudraz; Gabriel Bidaux; Nathan Mewton; Michel Ovize; Thomas Bochaton Journal: Immun Inflamm Dis Date: 2021-02-08
Authors: Hendrik M Willemsen; Gonda de Jong; René A Tio; Wybe Nieuwland; Ido P Kema; Iwan C C van der Horst; Mattijs Oudkerk; Felix Zijlstra Journal: BMC Cardiovasc Disord Date: 2009-06-15 Impact factor: 2.298
Authors: Payman Zamani; Gregory G Schwartz; Anders G Olsson; Nader Rifai; Weihang Bao; Peter Libby; Peter Ganz; Scott Kinlay Journal: J Am Heart Assoc Date: 2013-01-28 Impact factor: 5.501