Increased soluble platelet/endothelial cellular adhesion molecule-1 and osteonectin levels in patients with severe congestive heart failure. Independence of disease etiology, and antecedent aspirin therapy

Background: Platelet-endothelial interactions modulated by adhesion molecul es, may play an important role in the pathogenesis of congestive heart fail ure (CHF). Soluble levels of these molecules and platelet-derived substance s are reportedly elevated in patients with CHF. However, no data are availa ble on the plasma levels of Platelet/Endothelial Cell Adhesion Molecule-1 ( PECAM-1), and platelet-derived osteonectin in this growing population. Meth ods and Results: Soluble levels by ELISA were prospectively determined in p atients with severe CHF (n = 37) and correlated to etiology and antecedent aspirin use, and compared with 14 healthy control subjects. Left ventricula r dysfunction was attributed to idiopathic dilated cardiomyopathy in 18 and coronary artery disease in 19 patients. Twenty-one patients were aspirin-f ree and 16 patients were using aspirin (81-500 mg daily). Elevated soluble PECAM-1 (51.31+/-2.44 ng/ml, P = 0.0001), and osteonectin (826.27 +/- 22.37 ng/ml, P = 0.0001) were observed in patients with CHF, as compared to heal thy controls (32.56 +/- 1.21 ng/ml, and 478.02 +/- 31.32 ng/ml, respectivel y). Neither etiology of CHF, nor antecedent aspirin therapy significantly a ffects the levels of PECAM-1 or osteonectin. Conclusions: Despite long-term aspirin therapy and independently of the etiology of the disease, soluble PECAM-1 and osteonectin were elevated in the majority of patients with seve re CHF, suggesting platelet-endothelial activation. The present data provid e additional evidence that more potent anti-platelet and endothelial preser vation regimens deserve further study in the heart failure population. (C) 1999 European Society of Cardiology. All rights reserved.