SOLUBLE E-SELECTIN, ICAM-1 AND VCAM-1 LEVELS IN SYSTEMIC AND CORONARYCIRCULATION IN PATIENTS WITH VARIANT ANGINA

Objective: The purpose of this study was to assess whether the plasma levels of soluble adhesion molecules including E-selectin, intercellul ar adhesion molecule-1 (ICAM-1) and vascular cell adhesion molecule-1 (:VCAM-1) are elevated in patients with variant angina and whether the y are released in the coronary circulation. Methods: Antecubital venou s plasma samples were collected from 33 patients with variant angina, 22 patients with stable effort angina and 20 control subjects. Samples were also collected from the aortic root (AO) and the coronary sinus (CS) in 18 patients with variant angina before and after left coronary spasm induced by intracoronary injection of acetylcholine. The solubl e adhesion molecules were assayed by enzyme immunoassay. Results: Ante cubital venous plasma soluble E-selectin(P < .05), ICAM-1 (P < .01) an d VCAM-1 (NS) levels were higher in the variant angina group than in t he control group, respectively. The plasma soluble ICAM-1 level was al so higher (P < .01) in the variant angina group than in the stable eff ort angina group. In the variant angina group, both soluble ICAM-1 (P < .05) and VCAM-1 (P < .01) levels were significantly lower in CS than AO at baseline. In contrast, after the spasm the plasma soluble ICAM- 1 level was (P < .05) higher in CS than AO and the CS-AO differences o f soluble ICAM-1 (P < .05) and VCAM-1 (P < .05) increased as compared with the baseline, respectively. These values were remained unchanged in the stable effort angina group after rapid atrial pacing and in the control group after administration of acetylcholine. Conclusions: Cir culating plasma levels of both soluble E-selectin and ICAM-1 were elev ated in patients with variant angina, indicating an association of an inflammatory reaction with coronary spasm. Both soluble ICAM-1 and VCA M-1 appeared to be trapped in the coronary circulation at baseline and released into the coronary circulation following coronary spasm and r eperfusion in the patients. (C) 1997 Elsevier Science B.V.