Soluble intercellular adhesion molecule-1 (sICAM-1) and aortic valve calcification in the Multi-Ethnic Study of Atherosclerosis (MESA)

Background and aim of the study: Previous studies have reported associations between individual inflammatory biomarkers and aortic valve disease, but none has examined associations with, baseline prevalence or severity of aortic valve calcium (AVC), as measured with cardiac computed tomography (CT). The study aim was to determine whether specific inflammatory markers were associated with AVC in the Multi-Ethnic Study of Atherosclerosis (MESA) cohort. Methods: The associations of inflammatory biomarkers, including C-reactive protein (CRP), interleukin-6 (IL-6), fibrinogen, D-dimer, soluble intercellular adhesion molecule-1 (sICAM-1), heat shock protein 60 (Hsp60), soluble tumor necrosis factor receptor-1 (sTNF-R1), soluble tissue factor (sTF), soluble E-selectin and matrix metalloproteinases-3 and -9 (MMP-3 and -9) with baseline AVC prevalence and severity were examined. Results: After adjusting for age, gender, race and cardiovascular risk factors (smoking, hypertension, diabetes, total cholesterol, HDL, serum creatinine, body mass index and lipid-lowering therapy), the point prevalence ratios (95% confidence interval) for prevalent AVC were 1.20 (1.04,1.39) for sICAM-1, 1.13 (1.03, 1.24) for IL-6, and 1.11 (1.02, 1.21) for D-dimer. No other associations were statistically significant. When CRP, sICAM-1, IL-6 and D-dimer were modeled together, only sICAM-1 remained associated with increased AVC prevalence (1.18 (1.02, 1.38)). Only sICAM-1 was associated with increased AVC severity (relative difference (95% CI): 1.18 (1.00, 1.39)). Conclusion: In this large, multi-ethnic, asymptomatic cohort, sICAM-1 - a marker of endothelial perturbation - was the only biomarker associated with both an increased prevalence and severity of AVC.