ACUTE MYOCARDIAL-INFARCTION AND INCREASED SOLUBLE INTERCELLULAR-ADHESION MOLECULE-1 - A MARKER OF VASCULAR INFLAMMATION AND A RISK OF EARLYRESTENOSIS

Background Plasma levels of soluble intercellular adhesion molecule-1 (sICAM-1) have been shown to predict activities of inflammatory disord ers and malignancies. However, it is unknown whether the plasma level of sICAM-1 is increased in patients with acute myocardial infarction ( AMI) with coronary intervention and whether the levels have any diagno stic or predictive valves for vascular disease activity in patients wi th AMI. Methods We prospectively observed the time course of the plasm a sICAM-1 levels in 20 patients with AMI whose infarct-related coronar y artery was successfully recanalized by emergency balloon angioplasty . sICAM-1 was measured by enzyme-linked immunoassay. Results At admiss ion, 48 hours, 1 week, and 2 weeks after angioplasty, sICAM-1 levels w ere significantly elevated in patients who had early (3 weeks) resteno sis develop compared with those who did not (p < 0.05). At the other t ime points examined, there was a tendency of higher sICAM-1 levels in patients with than without restenosis (0.06 < p < 0.09). The relation of sICAM-1 levels and total white blood cell counts, neutrophil counts , or numbers of diseased major coronary artery branches was not statis tically significant. Conclusions A persistent increase in plasma sICAM -1 levels may indirectly implicate vascular inflammation, which could predict the risk of early coronary restenosis after emergency angiopla sty in patients with AMI. Hence, measurements of sICAM-1 in patients w ith AMI would serve as a potentially useful predictor of the risk of e arly postangioplasty restenosis.