SOLUBLE E-SELECTIN AND INTERCELLULAR-ADHESION MOLECULE-1 PLASMA-LEVELS INCREASE DURING ACUTE MYOCARDIAL-INFARCTION

Previous studies have shown that adhesion molecules play a crucial rol e in leukocyte-endothelium interactions that occur during myocardial i schemia and reperfusion. We assessed the plasma levels of the soluble form of E-selectin (sE-selectin) and intercellular adhesion molecule-1 (sICAM-1) in 15 patients with acute myocardial infarction (AMI) and i n 15 controls with chronic stable angina. In patients with AMI, the le vels of sE-selectin and sICAM-1 increased significantly during the fir st 8 h after infarction and subsequently decreased. Soluble E-selectin levels were inversely related to the peak plasma levels of creatine k inase-MB (CK-MB), and the time course of their appearance in plasma co rrelated with that of neutrophil count and plasma D-dimer. In individu al patients, peak and mean sICAM-1 levels correlated respectively with plasma D-dimer concentrations and monocyte count, but no correlation were found when their time courses were analyzed. Eight hours after sy mptom onset, the mean plasma sE-selectin levels were higher in patient s with AMI than in those with stable angina, whereas no significant di fferences were found in mean plasma sICAM-1 levels between the two gro ups at every time analyzed. In the acute phase of MI (a) sE-selectin a nd sICAM-1 levels increase during the first 8 h and subsequently decre ase; (b) the increase in sE-selectin probably reflects activation of e ndothelial cells, correlates with other inflammatory and coagulation p arameters, and is inversely related to the degree of myocardial damage ; and (c) sICAM-1 plasma levels do not represent a good marker of ''ce ll activation'' because they reflect activation of different cells and may be affected by different conditions.