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Soluble intercellular adhesion molecule-1 as a predictor of early adverse events in patients with chest pain compatible with myocardial ischemia.
Ann Emerg Med. 2001 Sep; 38(3):223-8.AE

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 cell activation. The aim of this study was to investigate the 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.

Authors+Show Affiliations

Department of Emergency Medicine, Albert Einstein Medical Center, Philadelphia, PA, USA. grahamhillis@hotmail.comNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Journal Article
Research Support, Non-U.S. Gov't

Language

eng

PubMed ID

11524640

Citation

Hillis, G S., et al. "Soluble Intercellular Adhesion Molecule-1 as a Predictor of Early Adverse Events in Patients With Chest Pain Compatible With Myocardial Ischemia." Annals of Emergency Medicine, vol. 38, no. 3, 2001, pp. 223-8.
Hillis GS, Terregino C, Taggart P, et al. Soluble intercellular adhesion molecule-1 as a predictor of early adverse events in patients with chest pain compatible with myocardial ischemia. Ann Emerg Med. 2001;38(3):223-8.
Hillis, G. S., Terregino, C., Taggart, P., Killian, A., Zhao, N., Kaplan, J., Dalsey, W. C., & Mangione, A. (2001). Soluble intercellular adhesion molecule-1 as a predictor of early adverse events in patients with chest pain compatible with myocardial ischemia. Annals of Emergency Medicine, 38(3), 223-8.
Hillis GS, et al. Soluble Intercellular Adhesion Molecule-1 as a Predictor of Early Adverse Events in Patients With Chest Pain Compatible With Myocardial Ischemia. Ann Emerg Med. 2001;38(3):223-8. PubMed PMID: 11524640.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Soluble intercellular adhesion molecule-1 as a predictor of early adverse events in patients with chest pain compatible with myocardial ischemia. AU - Hillis,G S, AU - Terregino,C, AU - Taggart,P, AU - Killian,A, AU - Zhao,N, AU - Kaplan,J, AU - Dalsey,W C, AU - Mangione,A, PY - 2001/8/29/pubmed PY - 2001/9/28/medline PY - 2001/8/29/entrez SP - 223 EP - 8 JF - Annals of emergency medicine JO - Ann Emerg Med VL - 38 IS - 3 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 cell activation. The aim of this study was to investigate the 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. SN - 0196-0644 UR - https://www.unboundmedicine.com/medline/citation/11524640/Soluble_intercellular_adhesion_molecule_1_as_a_predictor_of_early_adverse_events_in_patients_with_chest_pain_compatible_with_myocardial_ischemia_ L2 - https://linkinghub.elsevier.com/retrieve/pii/S0196-0644(01)83568-X DB - PRIME DP - Unbound Medicine ER -