(Circulation. 2001;103:491.)
© 2001 American Heart Association, Inc.
Clinical Investigation and Reports |
Soluble P-Selectin and the Risk of Future Cardiovascular Events
From the Center for Cardiovascular Disease Prevention (P.M.R., N.R.), the Leducq Center for Molecular and Genetic Epidemiology of Cardiovascular Disease (P.M.R., N.R.); the Divisions of Preventive Medicine (P.M.R., J.E.B.) and Cardiology (P.M.R.), Brigham and Women’s Hospital; and the Department of Pathology, Children’s Hospital Medical Center (N.R.), Harvard Medical School, Boston, Mass.
Correspondence to Dr Paul M. Ridker, Brigham and Women’s Hospital, 900 Commonwealth Ave East, Boston, MA 02215. E-mail pridker{at}partners.org
Background—P-selectin, a cell-surface adhesion molecule involved in leukocyte rolling and attachment, has been hypothesized to play a role in the initiation of atherosclerosis. However, little clinical data are available evaluating the role of soluble P-selectin in determining vascular risk.
Methods and Results—In a large-scale prospective study of apparently healthy women, we measured baseline plasma concentration of soluble P-selectin among 115 participants who subsequently developed cardiovascular events and among 230 age- and smoking-matched participants who remained free of disease during 3.5 years of follow-up. Overall, mean levels of soluble P-selectin were significantly higher at baseline among women who subsequently experienced cardiovascular events compared with those who did not (83.2 versus 69.3 ng/mL; P=0.003). The risk of future cardiovascular events increased with increasing quartiles of soluble P-selectin (P=0.02), such that women in the highest quartile at study entry had an age- and smoking-matched relative risk 2.2 times higher than those in the lowest quartile (95% confidence interval, 1.2 to 4.2; P=0.01). This effect was independent of traditional risk factors. For each quartile increase in soluble P-selectin, the risk of future cardiovascular events increased 28% (P=0.03) after additional adjustment for obesity, hypertension, hyperlipidemia, diabetes, and exercise frequency. The highest risks were observed among women with the very highest levels of P-selectin (>137.3 ng/mL, the 95th percentile cut point of the control distribution).
Conclusions—Soluble P-selectin levels are elevated among apparently healthy women at risk for future vascular events.
Key Words: inflammation • selectins • atherosclerosis • risk factors • cell adhesion molecules • myocardial infarction
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