SERUM CONCENTRATION OF SOLUBLE INTERCELLULAR ADHESION MOLECULE-1 AND RISKS OF FUTURE CORONARY ARTERY DISEASE OF GRAFT FAILURE IN HEART TRANSPLANT RECIPIENTS

Abstract

133 Background: The expression of intercellular adhesion molecule-1 (ICAM-1) on arterial and arteriolar endothelium during the first three months following transplantation is associated with subsequent development of coronary artery disease (CAD) and graft failure. We asked if these changes were associated with increasing serum concentrations of soluble ICAM-1 and if serum soluble ICAM-1 was associated with subsequent outcome. Methods: Serum concentrations of soluble ICAM-1 were studied in serial samples obtained during the first three months post transplant (3.4 ± 0.2/patient) from 65 cardiac allograft recipients using a sandwich enzyme-linked immunosorbant assay (ELISA) technique. Matching endomyocardial biopsies were studied immunohistochemically for the presence of arterial and arteriolar endothelial ICAM-1 expression. Serial coronary angiograms (3.3 ± 0.2/patient) were studied to evaluate the presence and severity of CAD. Results: We found a significant correlation between the presence of ICAM-1 in arterial and arteriolar endothelium during the first three months post-transplant and increasing concentrations of serum soluble ICAM-1 (p=0.005). Increasing serum soluble ICAM-1 was associated significantly with subsequent development of CAD (p < 0.001) and graft failure (p = 0.03). Cardiac allograft recipients with higher concentrations of serum soluble ICAM-1 also showed more severe CAD (p = 0.004). Conclusion: Expression of ICAM-1 on arterial and arteriolar endothelium in endomyocardial biopsies during the first three months post-transplant is associated with increasing concentrations of serum soluble ICAM-1 and increasing serum soluble ICAM-1 is associated with subsequent CAD and graft failure.