Soluble adhesion molecules and prediction of coronary heart disease: a prospective study and meta-analysis

Background Previous studies have suggested that circulating concentrations of soluble adhesion molecules are useful predictors of risk of coronary hea rt disease (CHD). Larger studies are needed, however, to test this hypothes is. Methods We measured serum concentrations of four soluble cell adhesion mole cules (intercellular adhesion molecule-1 [ICAM-1], vascular cell adhesion m olecule-1 [VCAM-1], E-selectin, and P-selectin) in the stored baseline seru m samples of 643 men with coronary heart disease and 1278 controls nested i n a prospective study of 5661 men who were monitored for 16 years. We also did a meta-analysis of previous relevant studies to place our findings in c ontext. Results Concentrations of soluble adhesion molecules were significantly ass ociated with one another, with other markers of inflammation, and with some classic coronary risk factors. For ICAM-1, the odds ratio for CHD was 1.68 (95% Cl 1.32-2.14) in a comparison of men in the top third with those in t he bottom third of baseline measurements after adjustments for age and town . This decreased to 1.11 (0.75-1.64) after adjustment for some classic coro nary risk factors and indicators of socioeconomic status. For the three oth er cell adhesion molecules, the odds ratios for CHD, first adjusted for age and town only, and then additionally adjusted for other risk factors, were : VCAM-1:1.26 (0.99-1.61) and 0.96 (0.66-1.40); E-selectin: 1.27 (1.00-1.61 ) and 1.13 (0.78-1.62); and P-selectin: 1.23 (0.96-1.56) and 1.20 (0.81-.1. 76). Interpretation The measurement of these adhesion molecules is unlikely to a dd much predictive information to that provided by more established risk fa ctors.