Value of serum-soluble intercellular adhesion molecule-1 for the noninvasive risk assessment of transplant coronary artery disease, posttransplant ischemic events, and cardiac graft failure
Value of serum-soluble intercellular adhesion molecule-1 for the noninvasive risk assessment of transplant coronary artery disease, posttransplant ischemic events, and cardiac graft failure
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DOI：
10.1161/01.cir.102.13.1549
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发表时间：
2000-09-26
期刊：
影响因子：
37.8
通讯作者：
Halbrook, HG
中科院分区：
文献类型：
--
作者：
Labarrere, CA;Nelson, DR;Halbrook, HG
动脉内皮细胞上的粘附分子与自发性动脉粥样硬化和移植后冠状动脉疾病（CAD）有关。我们研究了移植后即刻血清可溶性细胞间粘附分子-1（sICAM-1）升高是否是CAD、移植后缺血事件，方法和结果：我们首先研究了16例心脏移植受者的血清sICAM-1，（每例患者5.5 +/-0.7个样本）以确定与匹配的子宫内膜活检中动脉和小动脉内皮ICAM-1的存在最相关的截止点。临界值为308 ng/mL。随后，我们前瞻性地评估了130例受者移植后前3个月内获得的系列样本（每例患者5.3 ± 0.1）中的血清sICAM-1，并将早期sICAM-1水平与长期结局相关联。血清sICAM-1 >308 ng/mL，与动脉及小动脉内皮ICAM-1呈显著相关（P=0.02）。血清sICAM-1 >308 ng/mL的心脏移植受者发生CAD的风险是正常受者的2.67倍（95% CI，1.28 ~ 5.59，P=0.009），发生移植物衰竭的风险是正常受者的3.63倍（95% CI，1.05 ~ 12.5，P=0.04）。sICAM-1 >308 ng/mL的受体在移植后也发生了更严重的CAD（P=0.009）和更多的缺血事件（P=0.03）。结论血清sICAM-1水平可用于无创评估移植CAD、移植后缺血事件和心脏移植物衰竭的风险。
Background-Adhesion molecules on arterial endothelium have been implicated in spontaneous atherosclerosis and transplant coronary artery disease (CAD). We studied whether elevated serum-soluble intercellular adhesion molecule-1 (sICAM-1) during the immediate posttransplant period was a risk factor for CAD, posttransplant ischemic events, or cardiac graft failure.Methods and Results-We initially studied serum sICAM-1 in a subset of 16 cardiac allograft recipients (5.5 +/- 0.7 samples per patient) to determine a cutoff point that best correlated with presence of arterial and arteriolar endothelial ICAM-1 in matching endomyocardial biopsies. The cutoff value was 308 ng/mL. Subsequently, we prospectively evaluated serum sICAM-1 in serial samples (5.3 +/- 0.1 per patient) obtained during the first 3 months after transplantation in a validation subset of 130 recipients and correlated early sICAM-1 levels with long-term outcome. Serum sICAM-1 >308 ng/mL, correlated significantly with ICAM-1 on arterial and arteriolar endothelium (P=0.02). Cardiac allograft recipients with serum sICAM-1 >308 ng/mL had 2.67 (95% CI, 1.28 to 5.59, P=0.009) times greater risk of CAD and 3.63 (95% CI, 1.05 to 12.5, P=0.04) times greater risk of graft failure. Recipients with sICAM-1 >308 ng/mL also developed more severe CAD (P=0.009) and more ischemic events (P=0.03) after transplantation.Conclusions-Serum sICAM-1 levels can be used to noninvasively assess risk of transplant CAD, posttransplant ischemic events, and cardiac graft failure.