Immediate and late effects of coronary angiography on soluble endothelial cell markers and P-selectin in patients with and without coronary artery disease

Endothelial cell injury and platelet activation are considered primary even ts in the pathogenesis of coronary artery disease (CAD) and are marked by p lasma concentrations of von Willebrand factor (vWF) and soluble thrombomodu lin, and by soluble P-selectin, respectively. Because both endothelial cell s and platelets interact with contrast media, we aimed to detect immediate and 24-h changes in these markers following coronary angiography in patient s with and without CAD. Sixteen patients with angiographically proven CAD a nd 14 patients without significant coronary stenosis were investigated. Blo od samples were obtained from an antecubital vein before and 24 h after car diac catheterization, and from the coronary sinus before and immediately af ter angiography. Concentrations of the markers were determined using enzyme -linked immunosorbent assays. In the coronary sinus samples, the only signi ficant finding was an increase in levels of soluble P-selectin in the patie nts with CAD (P < 0.038). In the post-catheterization peripheral blood samp les, concentrations of soluble P-selectin (P = 0.004), vWF (P = 0.0007) and soluble thrombomodulin (P = 0.0013) were all increased in patients with CA D. In contrast, patients without CAD demonstrated increased levels of vWF o nly (P = 0.0015) in peripheral blood samples obtained 24 h after angiograph y. We conclude that both immediate and 24-h changes take place in endotheli al cells and platelet markers in response to cardiac catheterization, and t hat these changes are different in patients with angiographically proven CA D and in patients free of disease. These differences may reflect alteration s in endothelial cell or platelet reactivity in patients with CAD. Blood Co ag Fibrinol 10:381-387 (C) 1999 Lippincott Williams & Wilkins.