Soluble Vascular Cell Adhesion Molecules May be Protective of Future Cardiovascular Disease Risk: Findings from the PREVEND Prospective Cohort Study.
Soluble Vascular Cell Adhesion Molecules May be Protective of Future Cardiovascular Disease Risk: Findings from the PREVEND Prospective Cohort Study.
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DOI：
10.5551/jat.38836
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发表时间：
2017-08-01
影响因子：
4.4
通讯作者：
Dullaart RPF
中科院分区：
文献类型：
--
作者：
Kunutsor SK;Bakker SJL;Dullaart RPF
目的：可溶性细胞粘附分子，如血管细胞粘附分子-1（VCAM-1），细胞间粘附分子-1，E-选择素和P-选择素，已被认为与心血管疾病（CVD）风险相关;然而，VCAM-1和CVD风险之间的关联的性质和程度尚不确定。我们的目的是评估VCAM-1与CVD风险的关联，并确定其对CVD风险预测的潜在效用。方法：在2,638名参与者的PREVEND前瞻性研究中，在基线时测量VCAM-1浓度。风险比（95%置信区间[CI]）和CVD的风险区分措施（例如，C-指数）和重新分类（即，重新分类净改善）。结果：在中位随访9.9年期间，发生了614例CVD事件。血浆VCAM-1与几种心血管风险标志物弱相关。在校正了已确定的心血管危险因素的分析中，logeVCAM-1每增加1个标准差，CVD的风险比（95%CI）为0.91（0.84-0.99; P = 0.020），在对体重指数、饮酒量、甘油三酯、肾功能和C反应蛋白进行额外调整后保持一致;风险比（95% CI）0.89（0.82-0.97; P = 0.006）。比较VCAM-1水平的最高和最低五分位数，相应的校正风险比分别为0.74（0.57-0.96; P = 0.023）和0.70（0.54-0.91; P = 0.007）。将VCAM-1添加到包含传统风险因素的CVD风险预测模型中并没有改善C指数或净重新分类。结论：血浆VCAM-1与CVD呈独立负相关。然而，VCAM-1在CVD风险评估中没有提供超出常规CVD风险因素的显著改善。
Aim: Soluble cell adhesion molecules, such as vascular cell adhesion molecule-1 (VCAM-1), intercellular adhesion molecule-1, E-selectin, and P-selectin, have been suggested to be associated with cardiovascular disease (CVD) risk; however, the nature and magnitude of the association between VCAM-1 and CVD risk is uncertain. We aimed to assess the association of VCAM-1 with CVD risk and determine its potential utility for CVD risk prediction. Methods: VCAM-1 concentrations were measured at baseline in the PREVEND prospective study of 2,638 participants. Hazard ratios (95% confidence intervals [CI]) and measures of risk discrimination for CVD (e.g., C-index) and reclassification (i.e., net reclassification improvement) of participants were assessed. Results: During a median follow-up of 9.9 years, 614 CVD events occurred. Plasma VCAM-1 was weakly associated with several cardiovascular risk markers. In analyses adjusted for established cardiovascular risk factors, the hazard ratio (95% CI) for CVD per 1 standard deviation increase in loge VCAM-1 was 0.91 (0.84–0.99; P = 0.020), which remained consistent after additional adjustment for body mass index, alcohol consumption, triglycerides, renal function, and C-reactive protein; hazard ratio (95% CI) 0.89 (0.82–0.97; P = 0.006). Comparing the top versus bottom quintiles of VCAM-1 levels, the corresponding adjusted hazard ratios were 0.74 (0.57–0.96; P = 0.023) and 0.70 (0.54–0.91; P = 0.007) respectively. Adding VCAM-1 to a CVD risk prediction model containing conventional risk factors did not improve the C-index or net reclassification. Conclusions: Plasma VCAM-1 is inversely and independently associated with CVD. However, VCAM-1 provides no significant improvement in CVD risk assessment beyond conventional CVD risk factors.
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DOI：
10.1056/nejmoa1114248
发表时间：
2012-07-05
期刊：
The New England journal of medicine
影响因子：
--
作者：
Inker LA;Schmid CH;Tighiouart H;Eckfeldt JH;Feldman HI;Greene T;Kusek JW;Manzi J;Van Lente F;Zhang YL;Coresh J;Levey AS;CKD-EPI Investigators
通讯作者：
CKD-EPI Investigators
影响因子：
3.5
作者：
Kunutsor, Setor K.;Khan, Hassan;Laukkanen, Jari A.
通讯作者：
Laukkanen, Jari A.
影响因子：
39.3
作者：
Borggreve, Susanna E.;Hillege, Hans L.;Dullaart, Robin P. F.
通讯作者：
Dullaart, Robin P. F.
影响因子：
3.7
作者：
Kunutsor, Setor K.;Bakker, Stephan J. L.;Dullaart, Robin P. F.
通讯作者：
Dullaart, Robin P. F.
影响因子：
24
作者：
Greenland, Philip;Alpert, Joseph S.;Whitman, Gayle R.
通讯作者：
Whitman, Gayle R.