Abstract 16499: Association of Soluble Endothelial Cell Selective Adhesion Molecule (sESAM) with Cardiovascular Outcomes in Patients with Stable Ischemic Heart Disease: A Report from the Heart and Soul Study
Introduction: Recently discovered endothelial cell-selective adhesion molecule (ESAM) is selectively expressed on vascular endothelium and activated platelets and is postulated to play a role in atherogenesis. We investigated the association of serum ESAM (sESAM) levels with subsequent cardiovascular outcomes in a cohort of patients with stable ischemic heart disease.
Methods: We measured sESAM levels in 985 patients with stable ischemic heart disease enrolled between September 2000 and December 2002 in a prospective cohort study. Cox proportional hazards models were used to define the relationship between baseline sESAM levels and cardiovascular outcomes (composite of myocardial infarctions, all-cause mortality and heart failure hospitalizations).
Results: There were 451 occurrences of the composite endpoint over a median follow-up of 8.9 years. Events occurred more frequently in participants with sESAM levels in the highest quartile, 64% (158/246) vs. 34% (83/247) in the lowest quartile (p<0.0001) (Figure 1). After adjusting for demographic and clinical risk factors, compared to participants in the lowest quartile, participants in the highest ESAM quartile had a higher rate of the composite endpoint (hazard ratio (HR) 1.62, 95% CI 1.20-2.19, p=0.002) as well as its individual components: death (HR 1.56, 95% CI 1.13-2.16, p=0.007), myocardial infarction (HR 2.07, 95% CI 1.12-3.83, p=0.02), and heart failure hospitalizations (1.83, 95% CI 1.12-2.99, p=0.017). These associations were no longer significant after adjustment for renal function (estimated glomerular filtration rate) (composite endpoint HR 1.04, 95%CI 0.75 - 1.45, p=0.79).
Conclusion: ESAM levels are robustly associated with myocardial infarction, heart failure, and death after adjusting for demographic and clinical risk factors. The link between ESAM, cardiovascular risk and renal disease deserves further exploration.
- © 2012 by American Heart Association, Inc.