Expression of Vascular Cell Adhesion Molecule-1 in Peripheral Artery Disease is Enriched in Patients with Advanced Kidney Disease.

BACKGROUND

Serving as an inflammatory biomarker in patients under regular hemodialysis (HD), the arterial tissue expression of vascular cell adhesion molecule 1 (VCAM-1) in patients with different renal function has rarely been investigated and remains unclear.

METHODS

Fifty-one consecutive patients with peripheral arterial disease (PAD) who underwent percutaneous transluminal angioplasty were recruited and divided into a normal renal function group, chronic kidney disease (CKD) group, and HD group. Background disease, clinical and angiographic severity, and serum level of VCAM-1 in the three groups were analyzed. The tissue expression of VCAM-1 was quantitatively demonstrated by immunohistochemical (IHC) staining and protein extraction from cell membranes in another amputated cohort.

RESULTS

In PAD patients, the serum level of VCAM-1 was significantly elevated in the HD group compared with the other two groups (1990.2 ± 607.1 ng/ml vs. 1547.9 ± 511.2 ng/ml vs. 1161.0 ± 435.8 ng/ml, p < 0.001). Serum VCAM-1 was a prognostic factor of major adverse cardiac or limb events (odds ratio: 1.002, 95% confidence interval: 1.001-1.003, p = 0.003). The expression of VCAM-1 was higher in the PAD amputated arterial tissue of CKD and HD patients as demonstrated by quantitative analysis of IHC staining and quantitative membrane protein extraction.

CONCLUSIONS

VCAM-1 is a cardiovascular prognostic biomarker. Both serum level and the tissue expression of VCAM-1 were significantly higher in PAD patients with advanced kidney disease.