© 2003 European Society of Cardiology
The prognostic value of circulating soluble cell adhesion molecules in patients with chronic congestive heart failure
a Division of Cardiology, Cheng-Hsin General Hospital 45, Cheng-Hsin Street, Pei-Tou, Taipei, Taiwan, ROC
b Institute of Clinical Medicine, National Yang-Ming University School of Medicine, Taipei, Taiwan, ROC
c Faculty of Medicine, National Yang-Ming University, School of Medicine Taipei, Taiwan, ROC
d Division of Cardiology, Taipei Veterans General Hospital Taipei, Taiwan, ROC
e Department of Internal Medicine, Cheng-Hsin General Hospital 45, Cheng-Hsin Street, Pei-Tou, Taipei, Taiwan, ROC
* Corresponding author. Tel./fax: +886-2-28261242 E-mail address: yin.wh{at}msa.hinet.net
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Abstract |
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Background: Circulating soluble (s) cell adhesion molecules (CAMs) are elevated in patients with congestive heart failure (CHF) and may play an important role in the pathogenesis of CHF by mediating the cell–cell interactions of the immune response. However, clinical data about the prognostic value of sCAMs are sparse. The purpose of this study is to determine whether various sCAMs can provide prognostic information in patients with CHF.
Methods: We measured circulating levels of three sCAMs (vascular cell adhesion molecule-1, intercellular adhesion molecule-1, and sP-selectin) in 74 patients with symptomatic chronic CHF and left ventricular ejection fraction (LVEF) <50%. We compared these levels with those of a group of 19 age-matched control subjects. Major adverse cardiac events (death, heart transplantation or hospitalization with worsening CHF) during a median follow-up period of 240 days were determined.
Results: The concentrations of the three sCAMs in the 74 patients with CHF were significantly associated with one another. Their levels were higher than those of the control subjects and increased with the severity of CHF. Significantly higher sCAM levels were noted in those patients who had major adverse cardiac events during the follow-up period. There were significant negative correlations between LVEF and sCAMs. However, only high levels of sP-selectin were found to be an independent significant predictor of CHF by Cox proportional hazards analysis.
Conclusions: These findings indicate that the levels of these three sCAMs increase with the severity of CHF and are related to clinical outcomes. Among them, high levels of sP-selectin can provide prognostic information independently in patients with CHF.
Key Words: Cell adhesion molecules • Congestive heart failure • Major adverse cardiac event • Left ventricular ejection fraction
Received May 24, 2002; Revised October 3, 2002; Accepted November 20, 2002
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