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Enhanced endothelial activation in diabetic patients with unstable angina and non-Q-wave myocardial infarction

N T Mulvihill1, J B Foley, R T Murphy

  • 1Royal City of Dublin Hospital Research and Education Institute, Department of Cardiology, St James's Hospital, Dublin, Ireland. mulvihin@hotmail.com

Diabetic Medicine : a Journal of the British Diabetic Association
|March 21, 2002
PubMed

Insights

Diabetic patients with acute coronary syndromes show elevated soluble E-selectin levels, indicating increased endothelial activation. This may explain the poorer prognosis observed in diabetic individuals with these conditions.

Area of Science:

  • Cardiovascular Medicine
  • Endocrinology
  • Immunology

Background:

  • Diabetes mellitus (DM) is linked to chronic endothelial dysfunction.
  • Diabetic patients with acute coronary syndromes (ACS) face worse prognoses than non-diabetics.
  • ACS involves inflammation and increased expression of cellular adhesion molecules (CAMs).

Purpose of the Study:

  • To investigate soluble CAM levels in diabetic and non-diabetic patients with unstable angina (UA) and non Q-wave myocardial infarction (NQMI).
  • To characterize the expression of soluble intercellular adhesion molecule-1 (ICAM-1), vascular cell adhesion molecule-1 (VCAM-1), E-selectin, and P-selectin.

Main Methods:

  • Serum samples collected from UA/NQMI patients at presentation, 72 hours, and 3, 6, 12 months post-discharge.
  • Soluble ICAM-1, VCAM-1, E-selectin, and P-selectin levels measured using ELISA.
  • Study included 15 diabetic and 15 matched non-diabetic patients.

Main Results:

  • Soluble E-selectin levels were significantly higher in diabetic patients at all time points (e.g., 74 ± 10 ng/ml vs. 47 ± 3 ng/ml at presentation, P < 0.03).
  • Soluble P-selectin levels were lower in diabetic patients during follow-up (e.g., 134 ± 15 ng/ml vs. 225 ± 32 ng/ml at 3/12 months, P < 0.02).
  • No significant differences in soluble ICAM-1 and VCAM-1 levels were found between groups.

Conclusions:

  • Elevated soluble E-selectin in diabetic patients with UA/NQMI suggests enhanced endothelial activation.
  • This endothelial activation may contribute to the adverse prognosis in diabetic patients with ACS.
  • Further research is needed to explore the clinical implications of these findings.
Abstract

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