C-reactive protein, arterial endothelial activation, and development of transplant coronary artery disease

A prospective study

Carlos A. Labarrere, Joshua B. Lee, David R. Nelson, Mohammed Al-Hassani, Steven Miller, Douglas E. Pitts

Research output: Contribution to journalArticle

90 Citations (Scopus)

Abstract

Background: Arterial endothelial expression and raised serum concentrations of the soluble form of intercellular adhesion molecule-1 (ICAM-1) are implicated in development of transplant coronary artery disease. We investigated whether C-reactive protein, known to stimulate ICAM-1, was associated with increased ICAM-1 concentration and subsequent development of coronary artery disease. Methods: With sandwich ELISAs, we measured C-reactive protein and soluble ICAM-1 in serial serum samples obtained during the first 3 months after transplantation in 109 heart-transplant patients. Matching endomyocardial biopsy samples were screened immunohistochemically for arterial endothelial ICAM-1. Serial coronary angiograms were assessed for development, severity, and progression of coronary artery disease. Findings: We showed a significant correlation (p=0.001) between raised concentrations of C-reactive protein and arterial endothelial ICAM-1 expression in endomyocardial biopsy samples. We also noted a significant relation between C-reactive protein and soluble ICAM-1 concentrations soon after transplantation (p=0.003). Early raised C-reactive protein concentrations were associated with development (p=0.004), increased severity (p=0.02), and enhanced rate of progression (p=0.01) of coronary artery disease, and with heightened frequency of ischaemic events (p=0.049) and graft failure (p=0.04). Interpretation: C-reactive protein concentration can be used to identify heart-transplant patients at increased risk of coronary artery disease and graft failure. Treatments directed at reduction of C-reactive protein concentration could improve patients' outcome.

Original languageEnglish
Pages (from-to)1462-1467
Number of pages6
JournalThe Lancet
Volume360
Issue number9344
DOIs
StatePublished - Nov 9 2002

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Intercellular Adhesion Molecule-1
C-Reactive Protein
Coronary Artery Disease
Prospective Studies
Transplants
Transplantation
Biopsy
Serum
Angiography
Enzyme-Linked Immunosorbent Assay

ASJC Scopus subject areas

  • Medicine(all)

Cite this

C-reactive protein, arterial endothelial activation, and development of transplant coronary artery disease : A prospective study. / Labarrere, Carlos A.; Lee, Joshua B.; Nelson, David R.; Al-Hassani, Mohammed; Miller, Steven; Pitts, Douglas E.

In: The Lancet, Vol. 360, No. 9344, 09.11.2002, p. 1462-1467.

Research output: Contribution to journalArticle

Labarrere, Carlos A. ; Lee, Joshua B. ; Nelson, David R. ; Al-Hassani, Mohammed ; Miller, Steven ; Pitts, Douglas E. / C-reactive protein, arterial endothelial activation, and development of transplant coronary artery disease : A prospective study. In: The Lancet. 2002 ; Vol. 360, No. 9344. pp. 1462-1467.
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