Relationship between intracoronary and peripheral expression of soluble cell adhesion molecules

Background: Elevated levels of soluble cell adhesion molecules (sCAMs) have been reported in various coronary artery disease processes. The principle stimulus for expression of sCAMs is believed to he an inflamed atherosclero tic plaque within the coronary vessel. The relationship between levels of s CAMs in the coronary circulation and the peripheral circulation has not bee n defined. The primary aim of this study was to define the relationship bet ween levels of sCAMs sampled from the systemic circulation and from the cor onary circulation. We also set out to document the acute expression of solu ble CAMs following coronary angioplasty with or without stent implantation. Methods: The coronary sinus Mas cannulated in patients undergoing LAD angi oplasty. Samples were drawn from left coronary ostium (LCO) and coronary si nus (CS) and femoral vein simultaneously before, immediately after and 4 h after the PTCA procedure. Levels of sICAM-1, sVCAM-1. sE-selectin and sP-se lectin were measured using ELISA technique. Results: 10 patients (7 male/3 female, 61 +/- 11 y) entered the study. There was no significant difference in the levels of sICAM-1. sVCAM-1, sE-selectin and sPselectin whether samp led from left coronary ostium, coronary sinus or femoral vein at all time p oints. There was no significant change in the acute expression of sICAM-1, sVCAM-1 and sE-selectin following coronary angioplasty. Levels of sP-select in fell significantly during the PTCA procedure (142 +/- 7 ng/ml to 64 +/- 6 ng/ml, P < 0.001) but then rose again after 4 h and returned toward basel ine levels at 24 h. Conclusion: Levels of soluble CAMs sampled In the syste mic circulation directly reflect levels in the coronary circulation. Corona ry angioplasty results in rapid fall in levels of sP-selectin which returns : to normal within 24 h following the procedure. (C) 2001 Elsevier Science Ireland Ltd. All rights reserved.