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. CONCLUSION: Increased s-VCAM-1 levels were associated with calcific AS in patients with significant CAD.
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. CONCLUSION: Increased s-VCAM-1 levels were associated with calcific AS in patients with significant CAD.
Authors: Gian M Novaro; Ronit Katz; Ronnier J Aviles; John S Gottdiener; Mary Cushman; Bruce M Psaty; Catherine M Otto; Brian P Griffin Journal: J Am Coll Cardiol Date: 2007-10-29 Impact factor: 24.094