Albert Michelle A, Glynn Robert J, Buring Julie E, Ridker Paul M
Center for Cardiovascular Disease Prevention, Donald W. Reynolds Center for Cardiovascular Disease Research, Brigham and Women's Hospital, Harvard Medical School, Boston, MA 02115, USA.
Atherosclerosis. 2008 Mar;197(1):297-302. doi: 10.1016/j.atherosclerosis.2007.04.051. Epub 2007 Jul 20.
Soluble intercellular adhesion molecule-1 (sICAM-1) is a transmembrane protein involved in the migration and adhesion of leukocytes to the vascular endothelium. While some studies indicate that elevated baseline sICAM-1 levels predict cardiovascular events, most of these studies were done in men; moreover, uncertainty exists regarding whether sICAM-1 levels predict vascular events consistent with acute thrombosis versus atherosclerotic disease progression.
In this prospective evaluation of 23,984 apparently healthy women, we measured sICAM-1 levels and followed participants for the development of cardiovascular (CVD) endpoints typically associated with atherosclerotic disease progression with resultant vessel narrowing (percutaneous transluminal angioplasty and coronary artery bypass grafting) and endpoints typically associated with vascular thrombosis and vessel occlusion (myocardial infarction (MI), ischemic stroke and death from a coronary cause). During a mean follow-up of 10 years, there were 741 events. For vascular events indicative of coronary atherosclerotic disease progression with luminal narrowing, Cox-proportional hazards models revealed an increase in vascular event rates from the lowest to highest quintile of baseline sICAM-1 after adjustment for CVD risk factors [hazard ratios (HR): 1.0, 1.4, 1.1, 1.6, 1.6, p(trend)=0.008]. By contrast, for endpoints reflective of acute vessel thrombosis, we found no association with sICAM-1 levels [HR for myocardial infarction: 1.0, 1.2, 0.9, 1.2, 1.0, p(trend)=0.7; HR for stroke (CVA): 1.0, 0.9, 1.0, 1.0, 1.1, p(trend)=0.6; HR for cardiovascular death: 1.0, 0.9, 0.7, 0.7, 0.8, p(trend)=0.7] except among smokers (RR=1.0, 1.4, 2.8, 3.8, 3.7, p=0.007).
Among women without a history of cardiovascular disease, sICAM-1 levels are predictive of CVD events that reflect coronary atherosclerotic disease progression and vessel narrowing, but not those events associated with acute thrombosis/vessel occlusion.
可溶性细胞间黏附分子-1（sICAM-1）是一种跨膜蛋白，参与白细胞向血管内皮的迁移和黏附。虽然一些研究表明，基线sICAM-1水平升高可预测心血管事件，但这些研究大多是在男性中进行的；此外，sICAM-1水平是否能预测与急性血栓形成相对应的血管事件以及动脉粥样硬化疾病进展仍存在不确定性。
在这项对23984名表面健康女性的前瞻性评估中，我们测量了sICAM-1水平，并对参与者进行随访，观察通常与动脉粥样硬化疾病进展及由此导致的血管狭窄相关的心血管（CVD）终点事件（经皮腔内血管成形术和冠状动脉搭桥术），以及通常与血管血栓形成和血管闭塞相关的终点事件（心肌梗死（MI）、缺血性中风和冠状动脉疾病导致的死亡）。在平均10年的随访期间，共发生了741起事件。对于提示冠状动脉粥样硬化疾病进展伴管腔狭窄的血管事件，Cox比例风险模型显示，在调整心血管疾病危险因素后，基线sICAM-1从最低五分位数到最高五分位数，血管事件发生率增加[风险比（HR）：1.0、1.4、1.1、1.6、1.6，p（趋势）=0.008]。相比之下，对于反映急性血管血栓形成的终点事件，我们发现其与sICAM-1水平无关[心肌梗死的HR：1.0、1.2、0.9、1.2、1.0，p（趋势）=0.7；中风（CVA）的HR：1.0、0.9、1.0、1.0、1.1，p（趋势）=0.6；心血管死亡的HR：1.0、0.9、0.7、0.7、0.8，p（趋势）=0.7]，但吸烟者除外（RR=1.0、1.4、2.8、3.8、3.7，p=0.007）。
在无心血管疾病病史的女性中，sICAM-1水平可预测反映冠状动脉粥样硬化疾病进展和血管狭窄的心血管疾病事件，但不能预测与急性血栓形成/血管闭塞相关的事件。
