Abstract

Background: Adhesion molecules have been suggested as mediators of atherosclerotic inflammatory process. They may contribute to the pathogenesis of stable and unstable angina. Methods: The study group consisted of 59 patients with coronary artery disease: 27 patients with stable exertional angina (group A), 32 patients with unstable angina (group B). 20 healthy persons acted as controls (group C). Serum levels of soluble Intercellular Adhesion Molecule 1 (sICAM-1), Vascular Cell Adhesion Molecule 1 (sVCAM-1), sE-selectin, sP-selectin were measured both before and after the treadmill ECG stress test in groups A and C. In group B the measurements were carried out at 6, 24, and 48 hours following an episode of chest pain. Results: There were no differences between the baseline serum levels of adhesion molecules as determined in groups A and C. In patients with stable angina, the post-exercise concentrations of sE-selectin were significantly higher (68.8±29 ng/ml) in comparison to both baseline- (38.7±15 ng/ml), and group C-values (pre-exercise: 35.1±16; post-exercise: 49.9±15 ng/ml). In unstable patients, serum sP-selectin (190.1±99 ng/ml) and sVCAM-1 levels (1359±299 ng/ml) were higher when compared to those found in groups A (142.3±24; 962±352 ng/ml, respectively) and C (136.4±33; 851±168 ng/ml, respectively). Conclusions: Serum levels of soluble adhesion molecules in patients with stable angina are comparable to those of healthy persons. Stress test-induced increase of sE-selectin concentration may reflect endothelial response to exercise. Unstable angina is characterized by significant elevation of sP-selectin and sVCAM-1 serum levels which seems to be related to enhanced platelets and leukocytes activation.

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