Skip Navigation

European Heart Journal 2001 22(14):1226-1234; doi:10.1053/euhj.2000.2480
Copyright © 2001 by the European Society of Cardiology.
This Article
Right arrow Abstract Freely available
Right arrow Full Text (PDF)
Right arrow Alert me when this article is cited
Right arrow Alert me if a correction is posted
Services
Right arrow Email this article to a friend
Right arrow Similar articles in this journal
Right arrow Similar articles in ISI Web of Science
Right arrow Similar articles in PubMed
Right arrow Alert me to new issues of the journal
Right arrow Add to My Personal Archive
Right arrow Download to citation manager
Right arrow Search for citing articles in:
ISI Web of Science (35)
Right arrowRequest Permissions
Google Scholar
Right arrow Articles by O'malley, T
Right arrow Articles by Fox, K.A.A
Right arrow Search for Related Content
PubMed
Right arrow PubMed Citation
Right arrow Articles by O'malley, T
Right arrow Articles by Fox, K.A.A
Social Bookmarking
Add to CiteULike   Add to Connotea   Add to Del.icio.us  
What's this?

Early increase in levels of soluble inter-cellular adhesion molecule-1 (sICAM-1). Potential risk factor for the acute coronary syndromes

T O'malleya, C.A Ludlamb, R.A Riemermsac and K.A.A Foxd,f1

a Portiuncula Hospital, Ballinasloe, Co. Galway, Republic of Ireland
b Royal Infirmary of Edinburgh, Lauriston Place, Edinburgh, UK
c Cardiovascular Research Unit, Edinburgh, U.K.
d Cardiovascular Research, Department of Medical and Radiological Sciences, Cardiology, The University of Edinburgh, Edinburgh, Scotland, U.K.

revised October 2, 2000; accepted October 4, 2000

Abstract

Background Studies have shown disparate results in relation to the role of plasma concentrations of cell adhesion molecules in atherosclerosis. Moreover, the differentiation of primary vs secondary alterations of these markers, in response to myocardial injury, has not been clear. We measured specific soluble cell adhesion molecules and inflammatory markers in men admitted acutely with chest pain and compared them to healthy controls.

Methods and Results We prospectively studied men (total n=241), admitted acutely with chest pain (7·4±9·4h, 71% within 10h), unstable angina (n=67), acute myocardial infarction (n=47) and chest pain without ischaemic heart disease (n=45) and compared them with a stratified sample of randomly selected healthy controls (n=82). Soluble intercellular adhesion molecule (sICAM-1), endothelial selectin, vascular cell adhesion molecule, interleukin-6 and C-reactive protein were measured by ELISA and P-selectin expression by flow cytometry. Multiple regression analysis was used to control for the impact of classical risk factors. At baseline ICAM-1, interleukin-6 and C-reactive protein were significantly elevated in patient groups whereas no difference in vascular cell adhesion molecule or endothelial selectin was found. At 3 month follow-up, ICAM-1 level was unchanged in ischaemic heart disease patients. In all groups C-reactive protein and interleukin-6 levels were lower at review. ICAM-1 levels at follow-up were higher in ischaemic heart disease groups (but not in chest pain without ischaemic heart disease) relative to controls and remained so only in the unstable angina group following regression. sICAM-1, interleukin-6 and C-reactive protein strongly correlated with smoking. In the acute phase, ICAM-1 was confounded by smoking following regression and C-reactive protein and interleukin-6 remained significant in both ischaemic heart disease groups after multiple regression. There was no relationship to events which occurred in 23% of ischaemic heart disease patients (further acute myocardial infarction 5·3%, sudden cardiac death 0·9% or recurrent angina 16·7%).

Conclusion We found an inflammatory response with higher sICAM-1, interleukin-6 and C-reactive protein in patients presenting soon after developing an acute coronary syndrome. As sICAM-1 was not affected by the acute event this plasma marker may be an important risk factor for the development of the acute coronary syndrome, particularly unstable angina.

Key Words: Acute coronary syndrome, intercellular adhesion molecule, risk factor, inflammation

f1 Correspondence: K. A. A. Fox, Cardiovascular Research, Department of Medical and Radiological Sciences, Cardiology, The University of Edinburgh, Royal Infirmary of Edinburgh, Lauriston Place, Edinburgh EH3 9YW, U.K.

References

  1. Maseri A. Inflammation, atherosclerosis, and ischemic events—exploring the hidden side of the moon. N Engl J Med. 1997;336:1014–1016[Free Full Text]
  2. Maseri A. Ischaemic Heart Disease. A rational basis for clinical practice and clinical research. : Churchill Livingstone; 1995. p. 237–301
  3. Blann AD, Lip GY. Cell adhesion molecules in cardiovascular disease: what can soluble levels tell us? Heart. 1994;81:101–102
  4. Ghaisas NK, Shahi CN, Foley B. Elevated levels of circulating soluble adhesion molecules in peripheral blood of patients with unstable angina. Am J Cardiol. 1997;80:617–619[CrossRef][ISI][Medline]
  5. Shyu KG, Chang H, Lin CC, Kuan P. Circulating intercellular adhesion molecule-1 and E-selectin in patients with acute coronary syndrome. Chest. 1996;109:1627–1630[Abstract/Free Full Text]
  6. Haught WH, Mansour M, Rothlein R. Alterations in circulating intercellular adhesion molecule-1 and L-selectin: further evidence for chronic inflammation in ischemic heart disease. Am Heart J. 1996;132:1–8[CrossRef][ISI][Medline]
  7. Kilgore KS, Lucchesi BR. Reperfusion injury after myocardial infarction: the role of free radicals and the inflammatory response. Clinical Biochem. 1993;26:359–370[CrossRef][ISI][Medline]
  8. Gearing AJH, Newman W. Circulating adhesion molecules in disease. Immunology. 1993;14:506–512
  9. Campbell RW, Wallentin L, Verheugt FW. Management strategies for a better outcome in unstable coronary artery disease. Clin Cardiol. 1998;21:314–322[ISI][Medline]
  10. Biasucci LM, Colizzi C, Rizzello V, Vitrella G, Crea F, Liuzzo G. Role of inflammation in the pathogenesis of unstable coronary artery diseases. Scand J Clin Lab Invest. 1999;230:12–22
  11. Toss H, Lindah B, Siegbahn A, Wallentin L. Prognostic influence of increased fibrinogen and C-reactive protein levels in unstable coronary artery disease. FRISC Study Group. Fragmin during Instability in Coronary Artery Disease. Circulation. 1997;96:4204–4210[Abstract/Free Full Text]
  12. Haverkate F, Thompson SG, Pyke SD, Gallimore JR, Pepys M. Production of C-reactive protein and risk of coronary events in stable and unstable angina. European Concerted Action on Thrombosis and Disabilities Angina Pectoris Study Group. Br Med J. 1997;349:462–466
  13. Liuzzo G, Biasucci LM, Gallimore JR. The prognostic value of C-reactive protein and serum amyloid a protein in severe unstable angina [see comments]. N Engl J Med. 1994;331:417–424[Abstract/Free Full Text]
  14. Lanza GA, Guido V, Galeazzi MM. Prognostic role of heart rate variability in patients with a recent acute myocardial infarction. Am J Cardiol. 1998;82:1323–1328[CrossRef][ISI][Medline]
  15. Berk BC, Weintraub WS, Alexander RW. Elevation of C-reactive protein in ‘active’ coronary artery disease. Am J Card. 1990;65:168–172
  16. Oltrona L, Ardissino D, Merlini PA, Spinola A, Chiodo F, Pezzano A. C-reactive protein elevation and early outcome in patients with unstable angina pectoris. Am J Cardiol. 1997;80:1002–1006[CrossRef][ISI][Medline]
  17. Biasucci LM, Liuzzo G, Fantuzzi G. Increasing levels of interleukin (IL)-1Ra and IL-6 during the first 2 days of hospitalization in unstable angina are associated with increased risk of in-hospital coronary events. Circulation. 1999;99:2079–2084[Abstract/Free Full Text]
  18. Biasucci LM, Vitelli A, Liuzzo G. Elevated levels of interleukin-6 in unstable angina [see comments]. Circulation. 1996;94:874–877[Abstract/Free Full Text]
  19. Braunwald E. Unstable angina. A classification. Circulation. 1989;80:410–414[Free Full Text]
  20. Warkentin TE, Powling MJ, Hardisty RM. Measurement of fibrinogen binding to platelets in whole blood by flow cytometry: a micromethod for the detection of platelet activation. Br J Haematol. 1990;76:387–394[ISI][Medline]
  21. Janes SL, Wilson DJ, Chronos N, Goodall AH. Evaluation of whole blood flow cytometric detection of platelet bound fibrinogen on normal subjects and patients with activated platelets. Thromb Haemost. 1993;70:659–666[ISI][Medline]
  22. Braunwald E. Shattuck lecture—cardiovascular medicine at the turn of the millennium: triumphs, concerns, and opportunities. N Engl J Med. 1997;337:1360–1369[Free Full Text]
  23. Gurfinkel E, Bozovich G, Beck E, Testa E, Livellara B, Mautner B. Treatment with the antibiotic roxithromycin in patients with acute non-Q-wave coronary syndromes. The final report of the ROXIS Study [see comments]. Eur Heart J. 1999;20:121–127[Abstract/Free Full Text]
  24. Anderson JL, Muhlestein JB, Carlquist J. Randomized secondary prevention trial of azithromycin in patients with coronary artery disease and serological evidence for Chlamydia pneumoniae infection: The Azithromycin in Coronary Artery Disease: Elimination of Myocardial Infection with Chlamydia (ACADEMIC) study. Circulation. 1999;99:1540–1547[Abstract/Free Full Text]
  25. Juhan-Vague I, Pyke SD, Alessi MC, Jespersen J, Haverkate F, Thompson SG. Fibrinolytic factors and the risk of myocardial infarction or sudden death in patients with angina pectoris. ECAT Study Group. European Concerted Action on Thrombosis and Disabilities. Circulation. 1996;94:2057–2063[Abstract/Free Full Text]
  26. Ridker PM, Hennekens CH, Roitman-Johnson B, Stampfer MJ, Allen J. Plasma concentration of soluble intercellular adhesion molecule 1 and risks of future myocardial infarction in apparently healthy men. Lancet. 1998;351:88–92[CrossRef][ISI][Medline]
  27. Conn HO, Snyder N, Atterbury CE. The Berkson bias in action. Yale J Biol Med. 1979;52:141–147[ISI][Medline]
  28. Couffinhal TC, Duplaa C, Moreau C. Regulation of vascular cell adhesion molecule-1 and intercellular adhesion molecule-1 in human vascular smooth muscle cells. Circ Res. 1994;74:225–234[Abstract/Free Full Text]
  29. Yamazaki T, Seko Y, Tamatani T. Expression of intercellular adhesion molecule-1 in rat heart with ischaemia/reperfusion and limitation of infarct size by treatment with antibodies against cell adhesion molecules. Am J Pathol. 1993;143:410–418[Abstract]
  30. Simpson PJ, Fantone JC, Mickelson JK, Gallagher KP, Lucchesi BR. Identification of a time window for therapy to reduce experimental canine myocardial injury: suppression of neutrophil activation during 72 hours of reperfusion. Circ Res. 1988;63:1070–1079[Abstract/Free Full Text]
  31. Miwa K, Igawa A, Inoue H. Soluble E-selectin, ICAM-1 and VCAM-1 levels in systemic and coronary circulation in patients with variant angina. Cardiovas Res. 1997;36:37–44[Abstract/Free Full Text]
  32. Blann AD, McCollum CN. Increased levels of soluble adhesion molecules in atherosclerosis. Thromb Haemost. 1994;72:151–154[ISI][Medline]
  33. Hwang SJ, Ballantyne CM, Sharrett AR. Circulating adhesion molecules VCAM-1, ICAM-1 and E-selectin in carotid atherosclerosis and incident coronary heart disease cases: the Atherosclerosis Risk In Communities (ARIC) study. Circulation. 1997;96:4219–4225[Abstract/Free Full Text]
  34. Langford EJ, Wainwright RJ, Martin JF. Platelet activation in acute myocardial infarction and unstable angina is inhibited by nitric oxide donors. Arteriosclerosis, Thromb Vasc Biol. 1996;16:51–55[Abstract/Free Full Text]
  35. Tenaglia AN, Buda AJ, Wilkins RG. Levels of expression of P-selectin, E-selectin, and intercellular adhesion molecule-1 in coronary atherectomy specimens from patients with stable and unstable angina pectoris. Am J Cardiol. 1997;79:742–747[CrossRef][ISI][Medline]
  36. Singh N, Gemmell CH, Daly RA, Yeo EL. Elevated platelet-derived microparticle levels during unstable angina. Can J Card. 1995;11:1015–1021
  37. Sturk A, Hack CE, Aarden LA, Brouwer M, Koster RR, Sanders GT. Interleukin-6 release and the acute-phase reaction in patients with acute myocardial infarction: a pilot study. J Lab Clin Med. 1992;119:5749

Add to CiteULike CiteULike   Add to Connotea Connotea   Add to Del.icio.us Del.icio.us    What's this?


This article has been cited by other articles:


Home page
 Eur Heart JHome page
M. E. Bertrand, M. L. Simoons, K. A.A. Fox, L. C. Wallentin, C. W. Hamm, E. McFadden, P. J. De Feyter, G. Specchia, and W. Ruzyllo
Management of acute coronary syndromes in patients presenting without persistent ST-segment elevation
Eur. Heart J., December 1, 2002; 23(23): 1809 - 1840.
[Full Text] [PDF]

Home page
 Eur Heart JHome page
N.T. Mulvihill, B. Foley, P. Crean, and M. Walsh
Prediction of cardiovascular risk using soluble cell adhesion molecules
Eur. Heart J., October 2, 2002; 23(20): 1569 - 1574.
[Full Text] [PDF]

Home page
 CirculationHome page
A. D. Pradhan, N. Rifai, and P. M. Ridker
Soluble Intercellular Adhesion Molecule-1, Soluble Vascular Adhesion Molecule-1, and the Development of Symptomatic Peripheral Arterial Disease in Men
Circulation, August 13, 2002; 106(7): 820 - 825.
[Abstract] [Full Text] [PDF]

Home page
 Eur Heart JHome page
P.J.M. Best and B.J. Gersh
Cell adhesion molecules and inflammation in acute coronary syndromes: markers and emerging risk factors
Eur. Heart J., July 2, 2001; 22(14): 1155 - 1159.
[PDF]

This Article
Right arrow Abstract Freely available
Right arrow Full Text (PDF)
Right arrow Alert me when this article is cited
Right arrow Alert me if a correction is posted
Services
Right arrow Email this article to a friend
Right arrow Similar articles in this journal
Right arrow Similar articles in ISI Web of Science
Right arrow Similar articles in PubMed
Right arrow Alert me to new issues of the journal
Right arrow Add to My Personal Archive
Right arrow Download to citation manager
Right arrow Search for citing articles in:
ISI Web of Science (35)
Right arrowRequest Permissions
Google Scholar
Right arrow Articles by O'malley, T
Right arrow Articles by Fox, K.A.A
Right arrow Search for Related Content
PubMed
Right arrow PubMed Citation
Right arrow Articles by O'malley, T
Right arrow Articles by Fox, K.A.A
Social Bookmarking
Add to CiteULike   Add to Connotea   Add to Del.icio.us  
What's this?