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Serum levels of circulating adhesion molecules after coronary angioplasty
1Department of Cardiology, Koshigaya Hospital, Dokkyo University School of Medicine, Saitama, Japan.
Insights
Soluble adhesion molecules, including sICAM-1 and sP-selectin, increase in coronary sinus blood after angioplasty, indicating vessel injury. These changes correlate with restenosis, aiding in evaluating intervention site inflammation.
Area of Science:
- Cardiovascular Medicine
- Biomarkers
- Interventional Cardiology
Background:
- Restenosis remains a significant complication following coronary angioplasty.
- Cell adhesion molecules (CAMs) mediate inflammatory responses involving platelets, leukocytes, and endothelial cells, potentially contributing to restenosis.
- Understanding the role of soluble forms of CAMs (sCAMs) in post-angioplasty complications is crucial.
Purpose of the Study:
- To investigate serial changes in circulating sCAMs in patients undergoing coronary angioplasty.
- To determine the correlation between sCAM levels and angiographic outcomes, specifically the late loss index.
- To assess the potential of sCAM measurements in evaluating vessel wall injury and inflammation post-intervention.
Main Methods:
- Serial measurements of serum soluble intercellular adhesion molecule-1 (sICAM-1), P-selectin (sP-selectin), L-selectin (sL-selectin), and E-selectin (sE-selectin) were performed in coronary sinus and peripheral blood samples from 25 patients.
- Blood samples were collected at baseline and at 24 and 48 hours after coronary angioplasty.
- Quantitative coronary angiography (QCA) was used to assess the late loss index (LLI).
Main Results:
- Serum levels of sICAM-1 and sP-selectin significantly increased immediately after angioplasty in coronary sinus blood, with levels peaking at 48 and 24 hours, respectively.
- sL-selectin levels also increased at 24 and 48 hours post-angioplasty in the coronary sinus.
- These changes were localized to the coronary sinus and not observed in peripheral blood. sE-selectin levels remained unchanged. The LLI correlated with changes in sICAM-1, sL-selectin, and sP-selectin at 48 hours.
Conclusions:
- Circulating sICAM-1, sP-selectin, and sL-selectin levels rise in the coronary sinus after angioplasty, reflecting local vessel wall injury and inflammation.
- These elevated sCAM levels, particularly at 48 hours, are associated with the late loss index, suggesting a role in restenosis development.
- Monitoring sCAM levels may serve as a valuable tool for assessing the extent of vascular trauma and inflammation at the intervention site.
Abstract:
The activation of platelets, leukocytes, and vascular endothelial cells mediated by cell adhesion molecules may play a role in the mechanism of restenosis, which is still a significant complication after coronary angioplasty. We observed serial changes in the circulating soluble forms of adhesion molecules in 25 patients with coronary artery disease who underwent coronary angioplasty for a single lesion of the left anterior descending artery. Serum levels of sICAM-1 (p < 0.05) and sP-selectin (p < 0.05) were significantly increased immediately after angioplasty in the coronary sinus blood samples. These increases continued during the 48-hour observation period, and the maximum increase was seen 48 h after angioplasty for sICAM-1 (p < 0.01) and 24 h after angioplasty for sP-selectin (p < 0. 01). The level of sL-selectin increased 24 h (p < 0.01) and 48 h (p < 0.001) after angioplasty. These changes were not observed in the peripheral blood samples. The sE-selectin level did not change after angioplasty. A multiple regression analysis showed that the late loss index obtained from quantitative angiographic (QCA) analysis was correlated with the changes in sICAM-1 (r = 0.31, p < 0.05), sL-selectin (r = 0.28, p < 0.05), and sP-selectin (r = 0.26, p < 0. 05) 48 h after angioplasty in the coronary sinus blood samples, but was not correlated with procedural variables, other QCA variables, or the change in the sL-selectin level. The measurements of these adhesion molecule levels may help to evaluate traumatic vessel wall injury and inflammation at the intervention site after coronary angioplasty.