Higher Blood Vascular Cell Adhesion Molecule-1 is Related to the Increased Risk of Cardiovascular Events in Chronic Obstructive Pulmonary Disease

Figures & data

Table 1 Baseline Characteristics of Patients with COPD and Control Subjects

Variables	Healthy Control Subjects (n=102)	Patients with COPD (n=163)	P value
Age (years)	64.8 (60.1–72.1)	65.2 (60.9–72.6)	0.753
Sex (male/female)	48/54	77/86	0.844
VCAM-1 (ng/mL)	733.2±226.5	1034.6±345.1	<0.001

Notes: Data are presented as mean ± SD for normally distributed data and as median (interquartile range) for nonnormally distributed data.

Abbreviations: COPD, chronic obstructive pulmonary disease; VCAM-1, vascular cell adhesion molecule-1.

Table 2 Clinical Characteristics Among 163 Patients with COPD at Baseline

Variables	All Patients (n=163)	COPD without CV Events (n=122)	COPD with CV Events (n=41)	P value
Age (years)	65.2 (60.9–72.6)	63.4 (59.2–70.1)	66.3 (63.5–76.9)	0.017
Sex (men/women)	77/86	57/122	20/41	0.158
BMI	26.2 (23.4–27.3)	25.6 (22.5–27.7)	27.6 (24.6–28.9)	0.013
Current smoker, n (%)	26 (16.0)	20 (16.4)	6 (14.6)	0.206
Current drinker, n (%)	57 (35.0)	38 (31.1)	19 (46.3)	0.009
Admission systolic BP (mmHg)	127.9 (112.5–146.8)	126.1 (106.9–145.5)	128.5 (113.6–149.2)	0.113
Admission diastolic BP (mmHg)	78.7 (71.2–86.5)	77.5 (66.3–80.2)	79.6 (76.5–88.3)	0.327
LVEF, n (%)	63.1±4.3	65.7±4.9	60.2±4.1	<0.001
CVD history
Hypertension, n (%)	33 (20.2)	24 (19.7)	9 (22.0)	0.371
Diabetes mellitus, n (%)	48 (29.4)	35 (28.7)	13 (31.7)	0.295
Coronary heart disease, n (%)	33 (20.2)	18 (14.8)	15 (36.6)	0.002
Stroke, n (%)	23 (14.1)	10 (8.2)	13 (31.7)	<0.001
Others, n (%)	12 (7.4)	8 (6.6)	4 (9.8)	0.150
Treatments
ACEI/ARB	20/163	14/122	7/41	0.004
beta-Blocker	39/163	29/122	10/41	0.310
CCB	28/163	21/122	7/41	0.779
Diuretic	42/163	32/122	10/41	0.413
Lipid-lowering drug	24/163	18/122	6/41	0.272
Laboratory measurements
eGFR (mL/min/1.73 m^2)	56.8 (45.1–63.7)	63.1 (57.1–66.2)	52.7 (43.2–60.5)	<0.001
NT-proBNP (pg/mL)	623 (428–781)	437 (277–670)	688 (521–947)	<0.001
Hs-CRP (pg/mL)	7.3 (2.6–13.5)	5.7 (2.1–8.4)	9.8 (3.7–17.6)	<0.001
Hb (g/L)	105 (91–119)	113 (98–126)	101 (85–112)	<0.001
ALB (g/L)	38.1 (36.6–41.2)	39.2 (37.4–44.0)	36.3 (34.2–39.3)	<0.001
HbA1c (%)	5.8 (5.6–6.2)	5.8 (5.5–6.0)	6.1 (5.8–6.5)	0.088
LDL (mmol/L)	2.47±0.97	2.16±0.89	2.67±1.38	<0.001
VCAM-1 (ng/mL)	1034.6±345.1	947.8±293.2	1174.4±365.3	<0.001

Notes: Data are presented as mean ± SD for normally distributed data, as median (interquartile range) for nonnormally distributed data, and as n (%) for categoric variables.

Abbreviations: COPD, chronic obstructive pulmonary disease; CV, cardiovascular; BMI, body mass index; BP, blood pressure; LVEF, left ventricular ejection fraction; CVD, cardiovascular disease; ACEI, angiotensin-converting enzyme inhibitor; ARB, angiotensin receptor blocker; CCB, calcium channel blocker; eGFR, estimated glomerular filtration rate; NT-proBNP, N-terminal prohormone of B-type natriuretic peptide; Hb, hemoglobin; hs-CRP, hs-C reactive protein; ALB, albumin; HbA1c, glycosylated hemoglobin; LDL, low-density lipoprotein; VCAM-1, vascular cell adhesion molecule-1.

Table 3 The Association Between the CVD History and VCAM-1 in 163 Patients with COPD by Logistic Regression Analysis

Variables	Model 1	Model 2	Model 3
VCAM-1 levels (ng/mL)
Quartile 1	1.000 (ref.)	1.000 (ref.)	1.000 (ref.)
Quartile 2	1.314 (1.120–1.689)	1.245 (1.116–1.608)	1.215 (1.112–1.493)
Quartile 3	1.476 (1.235–1.924)	1.415 (1.220–1.855)	1.345 (1.183–1.751)
Quartile 4	1.964 (1.463–3.459)	1.841 (1.396–2.995)	1.750 (1.324–2.428)
P-trend	<0.001	0.001	0.012

Notes: Model 1: Adjusted for age and gender, Model 2: Adjusted for age, gender, BMI, current smoker, current drinker, admission systolic and diastolic BP, LVEF and treatments, Model 3: Adjusted for age, gender, BMI, current smoker, current drinker, admission systolic and diastolic BP, LVEF, treatments and laboratory measurements.

Abbreviations: CVD, cardiovascular disease; COPD, chronic obstructive pulmonary disease; VCAM-1, vascular cell adhesion molecule-1; BMI, body mass index; BP, blood pressure; LVEF, left ventricular ejection fraction.

Table 4 Cox Proportional Hazard Analysis for Predicting CV Events in 163 Patients with COPD

Variables	Model 1	Model 2	Model 3
VCAM-1 levels (ng/mL)
Quartile 1	1.000 (ref.)	1.000 (ref.)	1.000 (ref.)
Quartile 2	2.011 (1.400–3.691)	1.865 (1.313–3.207)	1.594 (1.210–3.088)
Quartile 3	2.460 (1.744–4.249)	2.217 (1.523–4.014)	2.154 (1.456–3.449)
Quartile 4	3.152 (2.093–6.150)	2.846 (1.774–5.871)	2.617 (1.673–5.328)
P-trend	<0.001	<0.001	<0.001

Notes: Model 1: Adjusted for age and gender, Model 2: Adjusted for age, gender, BMI, current smoker, current drinker, admission systolic and diastolic BP, LVEF, CVD history and treatments, Model 3: Adjusted for age, gender, BMI, current smoker, current drinker, admission systolic and diastolic BP, LVEF, CVD history, treatments and laboratory measurements.

Abbreviations: CVD, cardiovascular disease; COPD, chronic obstructive pulmonary disease; VCAM-1, vascular cell adhesion molecule-1; BMI, body mass index; BP, blood pressure; LVEF, left ventricular ejection fraction.

Figure 1 Kaplan–Meier analysis of cardiovascular (CV) events free stratified into 2 groups by the median levels of serum vascular cell adhesion molecule-1 (VCAM-1).