THE RELEASE OF SOLUBLE ADHESION MOLECULES ICAM-1 AND E-SELECTIN AFTERACUTE MYOCARDIAL-INFARCTION AND FOLLOWING CORONARY ANGIOPLASTY

Endothelial cells express surface adhesion molecules for leukocytes in response to myocardial ischaemia. These molecules may be released int o plasma by activated cells and be detectable in soluble form. Samples were collected from the peripheral vein of 14 consecutive patients wi th acute myocardial infarction (AMI) at the time of admission, 6 h, an d 1 and 5 days post-admission. Additionally, samples were drawn from t he coronary sinus ostium and peripheral artery of seven patients under going coronary angioplasty (PTCA) before and after the first balloon i nflation. We measured the plasma levels of soluble intercellular adhes ion molecule-1 (sICAM-1) and soluble E-selectin (sELAM-1). In patients with AMI plasma levels of sICAM-1 exceeded those observed in age and sex-matched healthy subjects, (mean+/-SEM; 220.6+/-18 ng/ml) at all th e time intervals assessed (358.9+/-24.5; 330.9+/-24.4; 379.4+/-39.7 an d 366.8+/-47.5 ng/ml, respectively, p<0.01). sELAM-1 levels, however, were normal on admission, increased at 6 h to 52.7+/-3.8 ng/ml, p<0.05 , and at day 1 (56.0+/-4.6 ng/ml) before decreasing to normal levels o n the fifth day. After brief myocardial ischaemia occurring during PTC A, an increased level of sICAM-1 was observed following balloon deflat ion in the coronary sinus (329.2+/-20 ng/ml; p<0.05) as compared to th e subjects undergoing coronary angiography, but not in the peripheral artery. sELAM-1 levels remained unchanged during angioplasty. Thus, so luble adhesion molecules expressed by activated endothelial cells are released into peripheral blood during both AMI and brief myocardial is chaemia and measurement of such molecules may prove useful for monitor ing vascular endothelium activation following myocardial ischaemia/nec rosis. (C) 1997 Elsevier Science Ireland Ltd.