Soluble P-selectin and the success of thrombolysis in acute myocardial infarction

Background: P-Selectin mediates adhesive interactions between platelets, le ukocytes and endothelium to forth thrombi. Our purpose was to investigate p lasma soluble(s) P-selectin levels in patients with acute myocardial infarc tion (aMI) and the effect of thrombolysis on P-selectin levels. Methods: Pa tients with aMI within the first 6 h of chest pain were enrolled prospectiv ely. sP-selectin levels were determined by ELISA in the plasma of patients with aMI (n=32), stable angina (n=18), and healthy controls (n=15). Samples were obtained before, 3 and 24 h after reperfusion therapy with tissue pla sminogen activator. Seven patients showed recurrent angina or failure to re perfuse. Results: sP-selectin levels were significantly higher in aMI group than other groups (86.7 +/-8.7 ng/ml, P <0.05). SP-selectin levels were si milar in stable angina and control groups (28.8 +/-4.4 vs. 25.4 +/-7.3 ng/m l, P=NS). A significant increase in sP-selectin levels was observed 3 h aft er successful thrombolysis and this was followed by a decrease to near the baseline level late after reperfusion. But patients with failed reperfusion showed sustained high sP-selectin levels after 24 h of thrombolysis (P <0. 05). Conclusion: The plasma sP-selectin level is elevated in aMI and it inc reases further following thrombolytic therapy. This increase is probably in duced by activation of endothelial cells or platelets after myocardial isch emia and reperfusion during aMI. As the elevated levels are sustained in pa tients with failed reperfusion, serial P-selectin levels may be used as a n on-invasive indicator of successful thrombolysis in aMI. (C) 2001 Elsevier Science Ireland Ltd. All rights reserved.