Soluble E-selectin is not a marker of unstable coronary plaque in serum ofpatients with ischemic heart disease

Increased level of soluble cell adhesion molecules may be a marker for athe rosclerosis and/or reflect complication of the atherosclerotic plaque. To t est whether expression of cell adhesion molecules is more pronounced in uns table versus stable coronary plaques, we measured the serum level of solubl e E-selectin (sE-selectin) in 99 consecutive patients admitted to the hospi tal for acute coronary syndromes (ACS) and in 61 patients with chronic coro nary artery disease (CAD) using a commercially available ELISA kit. We also measured the sE-selectin concentration in 20 sex- and age-matched subjects without clinical evidence of atherosclerosis, who served as controls. The mean sE-selectin level was higher in both groups of patients compared with controls (ACS, 35.0 +/- 23.4 ng/mL; chronic CAD, 32.9 +/- 21.0 ng/mL; contr ols, 14.5 +/- 6.6 ng/mL; one-way ANOVA, P = 0.001), but there was no differ ence between patients with ACS and chronic CAD. Furthermore, there was a tr end (P = 0.08) toward a decrease in sE-selectin with an increase in the ext ent and severity of CAD. In patients with ACS, the in-hospital cardiac even t rate was 8%. Although mean sE-selectin concentration tended to be higher in patients with (49.2 +/- 42.1 ng/mL) than in those without (33.8 +/- 21.3 ng/mL) in-hospital cardiac events, the difference was not significant. In 53 patients with ACS, C-reactive protein was measured and showed no correla tion with the sE-selectin concentration. These findings show that although sE-selectin concentration is elevated in the presence of clinically relevan t atherosclerosis, it does not further increase during the unstable phase o f the disease, indicating that sE-selectin is not a reliable indicator of a complicated atherosclerotic plaque.