Acute myocardial infarction and increased soluble intercellular adhesion molecule-1: a marker of vascular inflammation and a risk of early restenosis?

BACKGROUND

Plasma levels of soluble intercellular adhesion molecule-1 (sICAM-1) have been shown to predict activities of inflammatory disorders and malignancies. However, it is unknown whether the plasma level of sICAM-1 is increased in patients with acute myocardial infarction (AMI) with coronary intervention and whether the levels have any diagnostic or predictive values for vascular disease activity in patients with AMI.

METHODS

We prospectively observed the time course of the plasma sICAM-1 levels in 20 patients with AMI whose infarct-related coronary artery was successfully recanalized by emergency balloon angioplasty. sICAM-1 was measured by enzyme-linked immunoassay.

RESULTS

At admission, 48 hours, 1 week, and 2 weeks after angioplasty, sICAM-1 levels were significantly elevated in patients who had early (3 weeks) restenosis develop compared with those who did not (p < 0.05). At the other time points examined, there was a tendency of higher sICAM-1 levels in patients with than without restenosis (0.06 < p < 0.09). The relation of sICAM-1 levels and total white blood cell counts, neutrophil counts, or numbers of diseased major coronary artery branches was not statistically significant.

CONCLUSIONS

A persistent increase in plasma sICAM-1 levels may indirectly implicate vascular inflammation, which could predict the risk of early coronary restenosis after emergency angioplasty in patients with AMI. Hence, measurements of sICAM-1 in patients with AMI would serve as a potentially useful predictor of the risk of early postangioplasty restenosis.