Increased circulating soluble intercellular adhesion molecule-1 in acute myocardial infarction: A possible predictor of reperfusion ventricular arrhythmias

Objectives: Myocardial ischemia/reperfusion induces ventricular reperfusion arrhythmias (RAs). Significant parts of RAs are considered tb be evoked by oxygen free radicals. Inasmuch as activated leukocytes release oxygen free radicals, and as the intercellular adhesion molecule-1 (ICAM-1) plays a ma jor role in leukocyte infiltration, we examined whether there may be a rela tionship between plasma levers of soluble ICAM-1 (sICAM-1) and frequency of RAs in patients with acute myocardial infarction (AN1). Design: Prospective study comparing the two AMI patient groups with or with out RAs. Setting: Coronary care unit and cardiac catheterization laboratories in a g eneral hospital. Patients: Twenty-three AMI patients (eight women and 15 men, aged 32 to 79 yrs). Interventions: All patients received percutaneous balloon angioplasty with or without previous intracoronary thrombolysis. Significant RAs were defined as at least one of nonsustained ventricular tachycardia, multifocal premature Ventricular contraction, and frequent premature ventricular cont raction occurring Measurements and Main Results: Plasma sICAM-1 levels were measured using an enzyme-linked immunosorbent assay. The plasma sICAM-1 levels at admission were significantly greater in RA(+) (243 +/- 60 ng/mL) than RA(-) group (19 2 +/- 44 ng/mL) (p < .05). We followed plasma sICAM-1 levels up to 3 wks, a nd found that SICAM-1 levels were consistently higher in the RA(+) than the RA(-) group. Simple regression analysis showed no significant relationship between plasma sICAM-1 levels and age, systolic and diastolic blood pressu res, or serum creatine kinase activity. The two AMI groups showed no differ ences in age, gender, events of major coronary risk factors, preinfarction angina, and medication. Conclusions: The increase in the plasma levels of sICAM-1 was observed in p atients manifesting ventricular RAs. This increase in sICAM-1 levels was ob served as early as at admission. The increased plasma sICAM-1 levels may be a useful biochemical marker for predicting myocardial reperfusion injury s uch as RAs in AMI.