Soluble intercellular adhesion molecule-1 as a predictor of early adverse events in patients with chest pain presumed due to myocardial ischemia

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

    Research output: Contribution to journalArticle

    12 Citations (Scopus)

    Abstract

    Study objective: Inflammation plays an important role in acute coronary syndromes, and some evidence indicates that patients with a more pronounced vascular inflammatory response have a poorer outcome. Soluble intercellular adhesion molecule-1 (sICAM-1) is a specific marker for vascular endothelial aim of this study was to investigate the cell activation. prognostic value of plasma sICAM-1 levels in patients with acute chest pain compatible with myocardial ischemia.

    Methods: This prospective study was conducted at 2 urban university medical centers. The study cohort consisted of 119 consecutive patients with chest pain in whom myocardial ischemia was suspected clinically at presentation. Patients with conditions that affect sICAM-1 levels were ineligible. Cardiac troponin I (cTnI), C-reactive protein, and sICAM-1 levels were assayed at presentation to the emergency department. The primary end point was the occurrence of a serious cardiac event (death, nonfatal acute myocardial infarction, coronary revascularization) in the hospital.

    Results: Although sICAM-1 levels tended to be higher in patients with a serious cardiac event, there was no significant association. In contrast, a cTnI level greater than 0.2 ng/mL was a powerful predictor of an in-hospital serious cardiac event (odds ratio 16.3, 95% confidence interval [CI] 4.7 to 55.9; P<.0001). Soluble ICAM-1 levels of more than 260 ng/mL at presentation had a sensitivity for predicting a serious cardiac event of 63% (95% CI 46% to 81 %) but a specificity of only 47% (95% CI 38% to 57%).

    Conclusion: In a heterogeneous population of patients with chest pain compatible with myocardial ischemia, elevated sICAM-1 levels are poor predictors of an individual patient suffering a serious cardiac event in the hospital.

    Original languageEnglish
    Pages (from-to)223-228
    Number of pages5
    JournalAnnals of Emergency Medicine
    Volume38
    DOIs
    Publication statusPublished - 2001

    Keywords

    • ACUTE CORONARY SYNDROMES
    • P-SELECTIN
    • INFARCTION
    • EMERGENCY
    • DISEASE
    • RISK

    Cite this

    Soluble intercellular adhesion molecule-1 as a predictor of early adverse events in patients with chest pain presumed due to myocardial ischemia. / Hillis, Graham Scott; Terregino, C. A.; Taggart, P.; Killian, A.; Zhao, N.; Kaplan, J.; Dalsey, W. C.; Mangione, A.

    In: Annals of Emergency Medicine, Vol. 38, 2001, p. 223-228.

    Research output: Contribution to journalArticle

    Hillis, Graham Scott ; Terregino, C. A. ; Taggart, P. ; Killian, A. ; Zhao, N. ; Kaplan, J. ; Dalsey, W. C. ; Mangione, A. / Soluble intercellular adhesion molecule-1 as a predictor of early adverse events in patients with chest pain presumed due to myocardial ischemia. In: Annals of Emergency Medicine. 2001 ; Vol. 38. pp. 223-228.
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    title = "Soluble intercellular adhesion molecule-1 as a predictor of early adverse events in patients with chest pain presumed due to myocardial ischemia",
    abstract = "Study objective: Inflammation plays an important role in acute coronary syndromes, and some evidence indicates that patients with a more pronounced vascular inflammatory response have a poorer outcome. Soluble intercellular adhesion molecule-1 (sICAM-1) is a specific marker for vascular endothelial aim of this study was to investigate the cell activation. prognostic value of plasma sICAM-1 levels in patients with acute chest pain compatible with myocardial ischemia.Methods: This prospective study was conducted at 2 urban university medical centers. The study cohort consisted of 119 consecutive patients with chest pain in whom myocardial ischemia was suspected clinically at presentation. Patients with conditions that affect sICAM-1 levels were ineligible. Cardiac troponin I (cTnI), C-reactive protein, and sICAM-1 levels were assayed at presentation to the emergency department. The primary end point was the occurrence of a serious cardiac event (death, nonfatal acute myocardial infarction, coronary revascularization) in the hospital.Results: Although sICAM-1 levels tended to be higher in patients with a serious cardiac event, there was no significant association. In contrast, a cTnI level greater than 0.2 ng/mL was a powerful predictor of an in-hospital serious cardiac event (odds ratio 16.3, 95{\%} confidence interval [CI] 4.7 to 55.9; P<.0001). Soluble ICAM-1 levels of more than 260 ng/mL at presentation had a sensitivity for predicting a serious cardiac event of 63{\%} (95{\%} CI 46{\%} to 81 {\%}) but a specificity of only 47{\%} (95{\%} CI 38{\%} to 57{\%}).Conclusion: In a heterogeneous population of patients with chest pain compatible with myocardial ischemia, elevated sICAM-1 levels are poor predictors of an individual patient suffering a serious cardiac event in the hospital.",
    keywords = "ACUTE CORONARY SYNDROMES, P-SELECTIN, INFARCTION, EMERGENCY, DISEASE, RISK",
    author = "Hillis, {Graham Scott} and Terregino, {C. A.} and P. Taggart and A. Killian and N. Zhao and J. Kaplan and Dalsey, {W. C.} and A. Mangione",
    year = "2001",
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    TY - JOUR

    T1 - Soluble intercellular adhesion molecule-1 as a predictor of early adverse events in patients with chest pain presumed due to myocardial ischemia

    AU - Hillis, Graham Scott

    AU - Terregino, C. A.

    AU - Taggart, P.

    AU - Killian, A.

    AU - Zhao, N.

    AU - Kaplan, J.

    AU - Dalsey, W. C.

    AU - Mangione, A.

    PY - 2001

    Y1 - 2001

    N2 - Study objective: Inflammation plays an important role in acute coronary syndromes, and some evidence indicates that patients with a more pronounced vascular inflammatory response have a poorer outcome. Soluble intercellular adhesion molecule-1 (sICAM-1) is a specific marker for vascular endothelial aim of this study was to investigate the cell activation. prognostic value of plasma sICAM-1 levels in patients with acute chest pain compatible with myocardial ischemia.Methods: This prospective study was conducted at 2 urban university medical centers. The study cohort consisted of 119 consecutive patients with chest pain in whom myocardial ischemia was suspected clinically at presentation. Patients with conditions that affect sICAM-1 levels were ineligible. Cardiac troponin I (cTnI), C-reactive protein, and sICAM-1 levels were assayed at presentation to the emergency department. The primary end point was the occurrence of a serious cardiac event (death, nonfatal acute myocardial infarction, coronary revascularization) in the hospital.Results: Although sICAM-1 levels tended to be higher in patients with a serious cardiac event, there was no significant association. In contrast, a cTnI level greater than 0.2 ng/mL was a powerful predictor of an in-hospital serious cardiac event (odds ratio 16.3, 95% confidence interval [CI] 4.7 to 55.9; P<.0001). Soluble ICAM-1 levels of more than 260 ng/mL at presentation had a sensitivity for predicting a serious cardiac event of 63% (95% CI 46% to 81 %) but a specificity of only 47% (95% CI 38% to 57%).Conclusion: In a heterogeneous population of patients with chest pain compatible with myocardial ischemia, elevated sICAM-1 levels are poor predictors of an individual patient suffering a serious cardiac event in the hospital.

    AB - Study objective: Inflammation plays an important role in acute coronary syndromes, and some evidence indicates that patients with a more pronounced vascular inflammatory response have a poorer outcome. Soluble intercellular adhesion molecule-1 (sICAM-1) is a specific marker for vascular endothelial aim of this study was to investigate the cell activation. prognostic value of plasma sICAM-1 levels in patients with acute chest pain compatible with myocardial ischemia.Methods: This prospective study was conducted at 2 urban university medical centers. The study cohort consisted of 119 consecutive patients with chest pain in whom myocardial ischemia was suspected clinically at presentation. Patients with conditions that affect sICAM-1 levels were ineligible. Cardiac troponin I (cTnI), C-reactive protein, and sICAM-1 levels were assayed at presentation to the emergency department. The primary end point was the occurrence of a serious cardiac event (death, nonfatal acute myocardial infarction, coronary revascularization) in the hospital.Results: Although sICAM-1 levels tended to be higher in patients with a serious cardiac event, there was no significant association. In contrast, a cTnI level greater than 0.2 ng/mL was a powerful predictor of an in-hospital serious cardiac event (odds ratio 16.3, 95% confidence interval [CI] 4.7 to 55.9; P<.0001). Soluble ICAM-1 levels of more than 260 ng/mL at presentation had a sensitivity for predicting a serious cardiac event of 63% (95% CI 46% to 81 %) but a specificity of only 47% (95% CI 38% to 57%).Conclusion: In a heterogeneous population of patients with chest pain compatible with myocardial ischemia, elevated sICAM-1 levels are poor predictors of an individual patient suffering a serious cardiac event in the hospital.

    KW - ACUTE CORONARY SYNDROMES

    KW - P-SELECTIN

    KW - INFARCTION

    KW - EMERGENCY

    KW - DISEASE

    KW - RISK

    U2 - 10.1067/mem.2001.117199

    DO - 10.1067/mem.2001.117199

    M3 - Article

    VL - 38

    SP - 223

    EP - 228

    JO - Annals of Emergency Medicine

    JF - Annals of Emergency Medicine

    SN - 0196-0644

    ER -