冠心病患者可溶性血管黏附分子-1水平与钙化性主动脉瓣狭窄的关联

Linking soluble vascular adhesion molecule-1 level to calcific aortic stenosis in patients with coronary artery disease.

作者信息

Linhartova Katerina, Sterbakova Gabriela, Racek Jaroslav, Cerbak Roman, Porazikova Karolina, Rokyta Richard

机构信息

Department of Cardiology, Cardiovascular Center, Motol University Hospital;

出版信息

Exp Clin Cardiol. 2009 Fall;14(3):e80-3.

PMID:20098573

原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC2807782/

Abstract

BACKGROUND

Calcific aortic stenosis (AS) is an atherosclerosis-related process and the most common cause of valve disease requiring surgery.

OBJECTIVE

To assess the association of inflammatory markers with AS in advanced atherosclerosis.

METHODS

Consecutive patients with coronary artery disease (CAD) associated with AS were prospectively identified (mean transvalvular aortic gradient of 30 mmHg or greater). Subjects with aortic sclerosis (mean transvalvular aortic gradient of 10 mmHg or less) served as controls. All patients underwent clinical evaluation, echocardiography and coronary angiography.

RESULTS

One hundred twenty-two patients with AS (85 men) and 101 with aortic sclerosis (76 men) of similar CAD severity were enrolled. The AS patients were older (mean [+/- SD] 71+/-7 years versus 66+/-7 years; P<0.001), had higher soluble vascular adhesion molecule-1 (s-VCAM-1) levels (1533+/-650 mug/L versus 1157+/-507 mug/L; P<0.001), but lower soluble intercellular adhesion molecule-1 (s-ICAM-1) (254+/-81 mug/L versus 293+/-84 mug/L; P<0.01) and soluble E-selectin (53+/-28 mug/L versus 62+/-29 mug/L; P<0.05) levels. The two groups did not differ with respect to C-reactive protein level (3+/-2.9 mg/L versus 3.4+/-2.6 mg/L; P not significant). Higher s-VCAM-1 (OR 1.09, 95% CI 1.04 to 1.14; P<0.001) and lower s-ICAM-1 (OR 0.82, 95% CI 0.72 to 0.94; P<0.001) levels were associated with AS after adjustment for age.

CONCLUSION

Increased s-VCAM-1 levels were associated with calcific AS in patients with significant CAD.

摘要

背景

钙化性主动脉瓣狭窄（AS）是一种与动脉粥样硬化相关的病变，是需要手术治疗的瓣膜疾病的最常见原因。

目的

评估炎症标志物与晚期动脉粥样硬化中AS的关联。

方法

前瞻性纳入连续的伴有AS的冠心病（CAD）患者（平均跨瓣主动脉压差≥30 mmHg）。主动脉硬化患者（平均跨瓣主动脉压差≤10 mmHg）作为对照。所有患者均接受临床评估、超声心动图检查和冠状动脉造影。

结果

纳入了122例AS患者（85例男性）和101例主动脉硬化患者（76例男性），他们的CAD严重程度相似。AS患者年龄更大（平均[±标准差]71±7岁对66±7岁；P<0.001），可溶性血管细胞黏附分子-1（s-VCAM-1）水平更高（1533±650 μg/L对1157±507 μg/L；P<0.001），但可溶性细胞间黏附分子-1（s-ICAM-1）水平更低（254±81 μg/L对293±84 μg/L；P<0.01）以及可溶性E-选择素水平更低（53±28 μg/L对62±29 μg/L；P<0.05）。两组在C反应蛋白水平方面无差异（3±2.9 mg/L对3.4±2.6 mg/L；P无统计学意义）。校正年龄后，较高的s-VCAM-1（比值比1.09，95%可信区间1.04至1.14；P<0.001）和较低的s-ICAM-1（比值比0.82，95%可信区间0.72至0.94；P<0.001）水平与AS相关。