CLINICAL STUDIES
Plasma concentration of soluble vascular cell adhesion molecule-1 and subsequent cardiovascular risk
James A. de Lemos, MD*  ,
Charles H. Hennekens, MD|| and
Paul M. Ridker, MD, FACC* || 
* Center for Cardiovascular Disease Prevention, Brigham and Women’s Hospital, Boston, Massachusetts, USA
the Leducq Center for Molecular and Genetic Epidemology of Cardiovascular Disease; Division of Cardiovascular Medicine, Brigham and Women’s Hospital, Boston, Massachusetts, USA
Division of Preventive Medicine, Brigham and Women’s Hospital, Boston, Massachusetts, USA
|| Department of Medicine, University of Miami School of Medicine, Miami, Florida, USA
Manuscript received November 2, 1999;
revised manuscript received February 3, 2000,
accepted March 30, 2000.
Reprint requests and correspondence: Dr. James de Lemos, Brigham and Women’s Hospital, 75 Francis Street, Boston, Massachusetts 02115
jdelemos{at}rics.bwh.harvard.edu
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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Abbreviations and Acronyms
| | CAM | = cellular adhesion molecule | | CRP | = C-reactive protein | | HDL | = high density lipoprotein | | LDL | = low density lipoprotein | | MI | = myocardial infarction | | PHS | = Physicians’ Health Study | | sICAM-1 | = soluble intercellular adhesion molecule-1 | | sVCAM-1 | = soluble vascular cell adhesion molecule-1 |
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