Evaluation of serum levels of solubilized adhesion molecules and cytokine receptors in coronary heart disease

OBJECTIVES The diagnostic importance of circulating solubilized tumor necro sis factor-alpha receptor II (sTNF-alpha RII) and interleukin-2 receptor in coronary heart disease (CHD) was evaluated. In addition, these variables w ere correlated with solubilized adhesion molecule levels (i.e., intracellul ar adhesion molecule [ICAM], vascular cell adhesion molecule [VCAM], and E- selectin). BACKGROUND Atherosclerosis is considered to be a chronic inflammatory proce ss. Because the immunologic network presents an abundance of positive and n egative feedback mechanisms, information obtained from different immunologi c variables might be highly redundant. METHODS In a cross-sectional study design, 60 patients with angiographicall y proven CHD were compared with 60 individuals who had undergone coronary a ngiography but in whom no evidence of stenosis could be found (control subj ects). Angiography was performed at least one year before the study. Cytoki ne levels were determined by enzyme-linked immunosorbent assay technique an d evaluated by univariate and multivariate statistical methods. RESULTS All immunologic variables except E-selectin (p = 0.08) significantl y discriminated between patients and control subjects. Coronary artery bypa ss graft surgery after angiography did not lead to significant differences in the variables investigated in the patients with bypass surgery as compar ed with the subjects without bypass surgery. Receiver-operating characteris tics analysis showed comparable test accuracy for solubilized adhesion mole cules and cytokine receptors, Multivariate logistic regression analysis, in cluding age, revealed that only ICAM and sTNF-alpha RII were independently correlated with the presence of CHD. Patients belonging to the third tertil e of at least one of these two variables demonstrated a 1.6- to 2-fold incr eased relative risk for the presence of CHD. CONCLUSIONS We concluded that both circulating ICAM and TNF-alpha RII shoul d be further evaluated as markers for atherosclerotic changes in the corona ry system. (C) 1999 by the American College of Cardiology.