219099 Relationship between Markers of Endothelial Dysfunction and All-Cause Mortality

Tuesday, November 9, 2010 : 2:48 PM - 3:06 PM

Loretta R. Cain, MPH , Department of Community Medicine, West Virginia University School of Medicine, Morgantown, WV
Anoop Shankar, MD, PhD , Department of Community Medicine, West Virginia University School of Medicine, Morgantown, WV
Barbara Klein, MD, MPH , Department of Ophthalmology and Visual Sciences, University of Wisconsin School of Medicine and Public Health, Madison, WI
Ronald Klein, MD, MPH , Department of Ophthalmology and Visual Sciences, University of Wisconsin School of Medicine and Public Health, Madison, WI
     
Background: Animal studies show that endothelial dysfunction may have a causative role in the development of cardiovascular disease (CVD), the no. 1 killer of Americans. However, in humans, it is unclear whether markers of endothelial dysfunction such as intercellular adhesion molecule 1 (ICAM-1) and vascular adhesion molecule 1 (VCAM-1) are independently associated with all-cause mortality.

Hypothesis: We examined the hypothesis that higher levels of VCAM and ICAM-1 are positively associated with all-cause mortality.

Methods: We conducted a population-based, longitudinal cohort study in Beaver Dam, Wisconsin among 1755 subjects (56% women) aged ≥18 years. Serum VCAM and ICAM-1 were examined as quartiles (VCAM quartiles 1-4: 0-661.4 ng/ml, 661.5-784.2 ng/ml, 784.3-944.6 ng/ml and >944.6 ng/ml; ICAM quartiles 1-4: 0-237.5 ng/ml, 237.6-281.8 ng/ml, 281.9-334.6 ng/ml and >334.6 ng/ml. The main outcome of interest was all-cause mortality (n=580).

Results: Overall, there was a positive association between increasing quartiles of VCAM and ICAM with all-cause mortality, independent of age, education, smoking, alcohol intake, body mass index, hypertension, diabetes, and serum total cholesterol. Compared to the lowest quartiles of VCAM (referent) and ICAM (referent), the multivariable odds ratio (95% confidence interval) of all-cause mortality for VCAM quartiles 1-4 respectively were 1.158(0.85-1.56), 1.45(1.08-1.93) and 1.55(1.16-2.07) p-trend<0.0001 and for ICAM quartiles 1-4 respectively were 1.13(0.88-1.47), 1.10(0.86-1.42) and 1.50(1.17-1.91) p-trend<0.0001.

Conclusion: In conclusion, markers of endothelial dysfunction are positively associated with all-cause mortality.

Learning Areas:
Epidemiology
Public health biology
Public health or related research

Learning Objectives:
1. To examine the relationship between markers of endothelial dysfunction and all-cause mortality 2. To analyze the effect of confounding factors such as age education, smoking, alcohol intake, body mass index, hypertension, diabetes, and serum total cholesterol in the relation between markers of endothelial dysfunction and all-cause mortality in a multivariable model. 3.To analyze the relation between markers of endothelial dysfunction and all-cause mortality when stratified my gender.

Keywords: Death, Chronic (CVD)

Presenting author's disclosure statement:

Qualified on the content I am responsible for because: I completed all analyses concerning this abstract.
Any relevant financial relationships? No

I agree to comply with the American Public Health Association Conflict of Interest and Commercial Support Guidelines, and to disclose to the participants any off-label or experimental uses of a commercial product or service discussed in my presentation.

Back to: 4269.0: Chronic disease epidemiology