INCREASED PLASMA SOLUBLE INTERCELLULAR-ADHESION MOLECULE-1 LEVELS IN PATIENTS WITH ACUTE MYOCARDIAL-INFARCTION

Intercellular adhesion molecule-1 (ICAM-1) is a major ligand for 2 mem bers of the CD18 family of leukocyte integrin adhesion molecules and m ediates adhesion between leukocytes and stimulated endothelial cells. We examined plasma soluble ICAM-1 (sICAM-1) levels in 30 patients with acute myocardial infarction (AMI) within 6 h of symptom onset, 21 pat ients with unstable angina (UA), 35 patients with stable exertional an gina (SEA) and 21 control subjects. Plasma sICAM-1 levels (ng/ml) were significantly higher in both the acute and chronic phases of AMI and in the UA group than in the SEA and the control groups (195+/-14, 198/-16 in the acute and chronic phases of AMI, 188+/-11 in the UA group vs 142+/-7 in the SEA group, 141+/-10 in the control group, p<0.01). P lasma sICAM-1 levels were significantly higher in AMI patients when pr eceded by unstable angina than when not preceded by unstable angina at any point over the time course except 1 week after admission (p<0.01 vs admission, 12 h, 2 days, 3 days, 5 days, 2 weeks, 3 weeks. p<0.05 v s 24 h). These results suggest that the increase in sICAM-1 is associa ted with repeated episodes of myocardial ischemia and reperfusion not leading to myocardial necrosis. The increase in sICAM-1 may play an im portant role as an inflammatory component in the pathogenesis of the i schemic myocardium.