High sensitive CRP and sICAM-1 can predict Major Adverse Cardiovascular Events: MELEN Study: A Large Turkish Population Based Study

Objective: We aimed to evaluate the predictors of major adverse cardiovascular events (MACE) in a prospective population based study. Methods: This study included 153 participants aged>40 years with high and very high cardiovascular risk, and 50 participants aged>40 years with low cardiovascular risk according to the SCORE risk assessment. All the participants underwent a doppler ultrasound examination of carotid intima media thickness (CIMT), echocardiographic examination, ECG recording and various biochemical analyses. High-sensitivity Creactive protein (hsCRP) was measured with chemiluminescent immunometric assay, serum amyloid-A (SAA) protein, soluble intercellular adhesion molecule-1 (sICAM), apolipoprotein-B (ApoB) were measured with ELISA method. eNOS single-nucleotide polymorphism was detected using polymerase chain reaction and restriction fragment length polymorphism methods. The follow-up was done 36 months after the baseline admission. MACE was defined as cardiovascular mortality or myocardial infarction or stroke. Results: Frequency of MACE was higher in high and very high risk group according to low risk group. There were no significant differences in eNOS gene polymorphisms between the risk groups and control subjects, and no significant association between eNOS gene polymorphisms and MACE was detected. Age, ejection fraction (EF), CIMT, hsCRP, ApoB, sICAM-1, and SAA protein levels were all significantly associated with MACE in univariate logistic regression analyses. Multivariate analyses revealed that age (OR:1.08, CI:1.02-1.15, p=0.013), EF (OR:0.94, CI:0.89-0.99, p=0.016), hsCRP (OR:1.36, CI:1.12-1.67, p=0.003) and sICAM-1 (OR:81.0, CI: 1.04-6320, p=0.048) levels were the only independent predictors of MACE. Conclusion: Higher age, hsCRP and sICAM-1 levels and lower EF were independent predictors of MACE.