Luc Gérald, Arveiler Dominique, Evans Alun, Amouyel Philippe, Ferrieres Jean, Bard Jean-Marie, Elkhalil Latifa, Fruchart Jean-Charles, Ducimetiere Pierre
Department of Atherosclerosis, SERLIA-INSERM UR325, Institut Pasteur de Lille, 1, rue du Professeur Calmette, 59019 Lille, France.
Atherosclerosis. 2003 Sep;170(1):169-76. doi: 10.1016/s0021-9150(03)00280-6.
The Epidemiological Study of Myocardial Infarction Study which enrolled 9758 apparently healthy men aged 50-59 years, is a prospective cohort study designed to evaluate markers of coronary risk. Soluble forms of the intercellular adhesion molecule-1 (ICAM-1) and vascular cell adhesion molecule-1 (VCAM-1) levels were measured in plasma obtained at baseline from 317 subjects who suffered a coronary event during the 5-year follow-up and in twice the number of control subjects who were matched for center, age and day of inclusion in a nested case-control design. The relative risk associated with the highest compared with the lowest thirds of ICAM-1 (>625 versus <502 ng/ml) was 2.45 (95% CI: 1.64-3.65, P<0.001) without adjustment; it decreased moderately (RR: 2.09; 95% CI: 1.34-3.24, P<0.001) after control for lipid and non-lipid factors and remained significantly elevated after adjustment for C-reactive protein (CRP) (RR: 1.90; 95% CI: 1.21-2.96, P=0.005). Plasma ICAM-1 was essentially associated with the risk of myocardial infarction or coronary death and also with angina pectoris. Subjects with CRP presented elevated coronary risk only if ICAM-1 was high. An elevated level of VCAM-1 was not associated with any risk of future acute coronary event, or with angina pectoris. This data indicates that plasma levels of ICAM-1 may serve as risk markers for future coronary events whatever their clinical presentation and that risk is better defined using simultaneous measurements of ICAM-1 and CRP than any of these levels separately.
心肌梗死流行病学研究纳入了9758名年龄在50至59岁之间的表面健康男性，这是一项前瞻性队列研究，旨在评估冠心病风险标志物。在一项巢式病例对照研究中，对5年随访期间发生冠心病事件的317名受试者基线时采集的血浆，以及两倍数量的按中心、年龄和入选日期匹配的对照受试者的血浆，测量了细胞间黏附分子-1（ICAM-1）和血管细胞黏附分子-1（VCAM-1）的可溶性形式水平。未调整时，与ICAM-1最低三分位数（>625对<502 ng/ml）相比，最高三分位数相关的相对风险为2.45（95%CI：1.64 - 3.65，P<0.001）；在控制脂质和非脂质因素后适度降低（RR：2.09；95%CI：1.34 - 3.24，P<0.001），在调整C反应蛋白（CRP）后仍显著升高（RR：1.90；95%CI：1.21 - 2.96，P = 0.005）。血浆ICAM-1主要与心肌梗死或冠心病死亡风险相关，也与心绞痛相关。只有当ICAM-1高时，CRP升高的受试者才呈现升高的冠心病风险。VCAM-1水平升高与未来急性冠脉事件风险或心绞痛均无关。该数据表明，无论临床表现如何，血浆ICAM-1水平可作为未来冠心病事件的风险标志物，并且同时测量ICAM-1和CRP比单独测量任何一个水平能更好地定义风险。
