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ALCAM predicts future cardiovascular death in acute coronary syndromes: Insights from the PLATO trial.
Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Medicinska och farmaceutiska vetenskapsområdet, centrumbildningar mm, UCR-Uppsala Clinical Research Center. Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Medical Sciences. (kardiologi)
Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Medicinska och farmaceutiska vetenskapsområdet, centrumbildningar mm, UCR-Uppsala Clinical Research Center. (UCR)
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2019 (English)In: Atherosclerosis, ISSN 0021-9150, E-ISSN 1879-1484, Vol. 293, p. 35-41, article id S0021-9150(19)31602-8Article in journal (Refereed) Epub ahead of print
Abstract [en]

BACKGROUND AND AIMS: Activated leukocyte cell adhesion molecule (ALCAM) is upregulated during inflammation and involved in transmigration of leukocytes and T-cell activation. We hypothesized that ALCAM might be associated with recurrent events in patients with acute coronary syndromes (ACS).

METHODS: ALCAM was measured in serum obtained on admission, at discharge, 1 month and 6 months in a subgroup of 5165 patients admitted with ACS and included in the PLATelet inhibition and patient Outcomes (PLATO) trial (NCT00391872). The association between ALCAM and the composite endpoint and its components, including cardiovascular (CV) death, non-procedural spontaneous myocardial infarction (MI) or stroke during 1-year follow-up, was assessed by Cox proportional hazards models with incremental addition of clinical risk factors and biomarkers (including high-sensitivity troponin T, N-terminal pro-B-type natriuretic peptide and growth differentiation factor-15).

RESULTS: The median (Q1-Q3) concentration of ALCAM at admission was 97 (80-116) ng/mL. A 50% higher level of ALCAM on admission was associated with a hazard ratio (HR) of 1.16 (95% confidence interval [1.00-1.34] p = 0.043) for the composite endpoint in fully adjusted analysis, mainly driven by the association with CV death (HR 1.45 [1.16-1.82] p = 0.0012).

CONCLUSIONS: In patients with ACS, admission level of ALCAM was independently associated with adverse outcome including CV death even after adjustment for established inflammatory and cardiac biomarkers.

Place, publisher, year, edition, pages
2019. Vol. 293, p. 35-41, article id S0021-9150(19)31602-8
Keywords [en]
Activated leukocyte cell adhesion molecule, Acute coronary syndromes, CV death, Prognosis
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Medical and Health Sciences
Identifiers
URN: urn:nbn:se:uu:diva-401230DOI: 10.1016/j.atherosclerosis.2019.11.031PubMedID: 31835039OAI: oai:DiVA.org:uu-401230DiVA, id: diva2:1383071
Available from: 2020-01-07 Created: 2020-01-07 Last updated: 2020-01-07

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Åkerblom, AxelGhukasyan, TatevikJames, Stefan K.Siegbahn, AgnetaWallentin, Lars C.
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