Elevated soluble P-selectin levels are associated with an increased risk of early adverse events in patients with presumed myocardial ischemia

Graham Scott Hillis, C. A. Terregino, P. Taggart, A. Killian, N. Zhao, W. C. Dalsey, A. Mangione

    Research output: Contribution to journalArticle

    49 Citations (Scopus)

    Abstract

    Background Cell adhesion molecules (CAMs) play a pivotal role in the interactions between leukocytes, platelets, and vascular endothelium. Soluble CAMs (sCAMs) are shed from cell surfaces and reflect cellular activation. Elevated levels of sCAMs have been reported in the acute coronary syndromes. We hypothesized, therefore, that sCAMs might prove of prognostic value in patients with acute chest pain presumed to be the result of myocardial ischemia.

    Methods One hundred twenty-six consecutive patients with chest pain, thought clinically to represent myocardial ischemia, were studied prospectively. Soluble intercellular adhesion molecule-1 (sICAM-1), vascular cell adhesion molecule-1 (sVCAM-1), E-selectin (sE-selectin) and P-selectin (sP-selectin) levels were assayed at presentation, as were cardiac troponin 1 (cTnl) and creatine kinase-MBmass (CK-MBmass). The primary study end point was the occurrence of a serious cardiac event (SCE) during the index admission or the subsequent 3 months.

    Results sP-selectin and cTnl levels were significantly higher among patients who had an early SCE (P = .006 and P < .001, respectively). Both remained independently predictive (P < .001) in a multivariate regression equation. The other independent predictor was a history of vascular disease (P < .05). No other markers were significant predictors of early outcome.

    Conclusion Elevated sP-selectin levels, but not those of other sCAMs, are predictors of early adverse events in patients with chest pain presumed caused by myocardial ischemia. Their utility in predicting the outcome of individual patients is, however, limited.

    Original languageEnglish
    Pages (from-to)235-241
    Number of pages6
    JournalAmerican Heart Journal
    Volume143
    DOIs
    Publication statusPublished - 2002

    Keywords

    • INTERCELLULAR-ADHESION MOLECULE-1
    • ACUTE CORONARY SYNDROMES
    • UNSTABLE ANGINA
    • CHEST PAIN
    • ENDOTHELIAL-CELLS
    • HEART-DISEASE
    • ATHEROSCLEROSIS
    • INFARCTION
    • INTERLEUKIN-6
    • EMERGENCY

    Cite this

    Elevated soluble P-selectin levels are associated with an increased risk of early adverse events in patients with presumed myocardial ischemia. / Hillis, Graham Scott; Terregino, C. A.; Taggart, P.; Killian, A.; Zhao, N.; Dalsey, W. C.; Mangione, A.

    In: American Heart Journal, Vol. 143, 2002, p. 235-241.

    Research output: Contribution to journalArticle

    Hillis, Graham Scott ; Terregino, C. A. ; Taggart, P. ; Killian, A. ; Zhao, N. ; Dalsey, W. C. ; Mangione, A. / Elevated soluble P-selectin levels are associated with an increased risk of early adverse events in patients with presumed myocardial ischemia. In: American Heart Journal. 2002 ; Vol. 143. pp. 235-241.
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    title = "Elevated soluble P-selectin levels are associated with an increased risk of early adverse events in patients with presumed myocardial ischemia",
    abstract = "Background Cell adhesion molecules (CAMs) play a pivotal role in the interactions between leukocytes, platelets, and vascular endothelium. Soluble CAMs (sCAMs) are shed from cell surfaces and reflect cellular activation. Elevated levels of sCAMs have been reported in the acute coronary syndromes. We hypothesized, therefore, that sCAMs might prove of prognostic value in patients with acute chest pain presumed to be the result of myocardial ischemia.Methods One hundred twenty-six consecutive patients with chest pain, thought clinically to represent myocardial ischemia, were studied prospectively. Soluble intercellular adhesion molecule-1 (sICAM-1), vascular cell adhesion molecule-1 (sVCAM-1), E-selectin (sE-selectin) and P-selectin (sP-selectin) levels were assayed at presentation, as were cardiac troponin 1 (cTnl) and creatine kinase-MBmass (CK-MBmass). The primary study end point was the occurrence of a serious cardiac event (SCE) during the index admission or the subsequent 3 months.Results sP-selectin and cTnl levels were significantly higher among patients who had an early SCE (P = .006 and P < .001, respectively). Both remained independently predictive (P < .001) in a multivariate regression equation. The other independent predictor was a history of vascular disease (P < .05). No other markers were significant predictors of early outcome.Conclusion Elevated sP-selectin levels, but not those of other sCAMs, are predictors of early adverse events in patients with chest pain presumed caused by myocardial ischemia. Their utility in predicting the outcome of individual patients is, however, limited.",
    keywords = "INTERCELLULAR-ADHESION MOLECULE-1, ACUTE CORONARY SYNDROMES, UNSTABLE ANGINA, CHEST PAIN, ENDOTHELIAL-CELLS, HEART-DISEASE, ATHEROSCLEROSIS, INFARCTION, INTERLEUKIN-6, EMERGENCY",
    author = "Hillis, {Graham Scott} and Terregino, {C. A.} and P. Taggart and A. Killian and N. Zhao and Dalsey, {W. C.} and A. Mangione",
    year = "2002",
    doi = "10.1067/mhj.2002.120303",
    language = "English",
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    pages = "235--241",
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    }

    TY - JOUR

    T1 - Elevated soluble P-selectin levels are associated with an increased risk of early adverse events in patients with presumed myocardial ischemia

    AU - Hillis, Graham Scott

    AU - Terregino, C. A.

    AU - Taggart, P.

    AU - Killian, A.

    AU - Zhao, N.

    AU - Dalsey, W. C.

    AU - Mangione, A.

    PY - 2002

    Y1 - 2002

    N2 - Background Cell adhesion molecules (CAMs) play a pivotal role in the interactions between leukocytes, platelets, and vascular endothelium. Soluble CAMs (sCAMs) are shed from cell surfaces and reflect cellular activation. Elevated levels of sCAMs have been reported in the acute coronary syndromes. We hypothesized, therefore, that sCAMs might prove of prognostic value in patients with acute chest pain presumed to be the result of myocardial ischemia.Methods One hundred twenty-six consecutive patients with chest pain, thought clinically to represent myocardial ischemia, were studied prospectively. Soluble intercellular adhesion molecule-1 (sICAM-1), vascular cell adhesion molecule-1 (sVCAM-1), E-selectin (sE-selectin) and P-selectin (sP-selectin) levels were assayed at presentation, as were cardiac troponin 1 (cTnl) and creatine kinase-MBmass (CK-MBmass). The primary study end point was the occurrence of a serious cardiac event (SCE) during the index admission or the subsequent 3 months.Results sP-selectin and cTnl levels were significantly higher among patients who had an early SCE (P = .006 and P < .001, respectively). Both remained independently predictive (P < .001) in a multivariate regression equation. The other independent predictor was a history of vascular disease (P < .05). No other markers were significant predictors of early outcome.Conclusion Elevated sP-selectin levels, but not those of other sCAMs, are predictors of early adverse events in patients with chest pain presumed caused by myocardial ischemia. Their utility in predicting the outcome of individual patients is, however, limited.

    AB - Background Cell adhesion molecules (CAMs) play a pivotal role in the interactions between leukocytes, platelets, and vascular endothelium. Soluble CAMs (sCAMs) are shed from cell surfaces and reflect cellular activation. Elevated levels of sCAMs have been reported in the acute coronary syndromes. We hypothesized, therefore, that sCAMs might prove of prognostic value in patients with acute chest pain presumed to be the result of myocardial ischemia.Methods One hundred twenty-six consecutive patients with chest pain, thought clinically to represent myocardial ischemia, were studied prospectively. Soluble intercellular adhesion molecule-1 (sICAM-1), vascular cell adhesion molecule-1 (sVCAM-1), E-selectin (sE-selectin) and P-selectin (sP-selectin) levels were assayed at presentation, as were cardiac troponin 1 (cTnl) and creatine kinase-MBmass (CK-MBmass). The primary study end point was the occurrence of a serious cardiac event (SCE) during the index admission or the subsequent 3 months.Results sP-selectin and cTnl levels were significantly higher among patients who had an early SCE (P = .006 and P < .001, respectively). Both remained independently predictive (P < .001) in a multivariate regression equation. The other independent predictor was a history of vascular disease (P < .05). No other markers were significant predictors of early outcome.Conclusion Elevated sP-selectin levels, but not those of other sCAMs, are predictors of early adverse events in patients with chest pain presumed caused by myocardial ischemia. Their utility in predicting the outcome of individual patients is, however, limited.

    KW - INTERCELLULAR-ADHESION MOLECULE-1

    KW - ACUTE CORONARY SYNDROMES

    KW - UNSTABLE ANGINA

    KW - CHEST PAIN

    KW - ENDOTHELIAL-CELLS

    KW - HEART-DISEASE

    KW - ATHEROSCLEROSIS

    KW - INFARCTION

    KW - INTERLEUKIN-6

    KW - EMERGENCY

    U2 - 10.1067/mhj.2002.120303

    DO - 10.1067/mhj.2002.120303

    M3 - Article

    VL - 143

    SP - 235

    EP - 241

    JO - American Heart Journal

    JF - American Heart Journal

    SN - 0002-8703

    ER -