Ad. Blann et al., INCREASED SOLUBLE P-SELECTIN FOLLOWING MYOCARDIAL-INFARCTION - A NEW MARKER FOR THE PROGRESSION OF ATHEROSCLEROSIS, Blood coagulation & fibrinolysis, 8(7), 1997, pp. 383-390
Increased soluble P-selectin has been described in atherosclerosis, bu
t the mechanisms for this and its clinical significance are unknown. I
n an attempt to clarify these points we measured soluble P-selectin an
d von Willebrand factor, an endothelial cell marker, by ELISA in 116 p
atients who had survived a myocardial infarction and in 116 matched co
ntrols. Raised levels of both soluble P-selectin (median 272 ng/ml, ra
nge 55-850 ng/ml us 190 ng/ml, range 40-395 ng/ml) and von Willebrand
factor (mean +/- SD 128 +/- 37 IU/dl vs 100 +/- 33 IU/dl; both P < 0.0
01) failed to correlate (r = 0.12), and soluble P-selectin failed to c
orrelate with any of the major risk factors for atherosclerosis. A fou
r-year follow-up of 68 of these patients revealed that soluble P-selec
tin was higher in the 33 (48%) who had suffered an additional cardiova
scular event (e.g. subsequent myocardial infarction, arterial surgery;
median 350 ng/ml, range 275-460 ng/ml) compared with those free of an
end-point (270 ng/ml, range 140-400 ng/ml, P = 0.0012). We conclude t
hat increased soluble P-selectin is unrelated to the risk factors for
atherosclerosis but is a new marker of disease progression in patients
who have survived a myocardial infarction.