Soluble E-Selectin Levels in Acute Human Myocardial Infarction

It has been suggested that leukocyte adhesion mechanisms play a key role in experimental myocardial infarction. We have recently shown that E-selectin, an adhesion molecule belonging to the selectin family, is involved in the pathogenesis of experimental myocardial ischemia. We investigated the circulating levels of E-selectin, studied as a marker of endothelial dysfunction, in acute myocardial infarction. Our study was carried out in 60 patients, 20 hospitalized for acute myocardial infarction, 20 suffered from angina pectoris and 20 healthy control subjects. Patients with acute myocardial infarction had increased serum levels of soluble E-selectin (sE-selectin = 255 ± 12 ng/ml) compared to both patients with angina pectoris (sE-selectin = 46 ± 10 ng/ml) and healthy control subjects (sE-selectin = 51 ± 14 ng/ml). Thrombolytic therapy with urokinase (1,000,000 IU as an intravenous bolus in 5 min, followed by an infusion of additional 1,000,000 IU for the following 2 h) succeeded in producing reperfusion and reduced the serum levels of sE-selectin (71 ± 19 ng/ml). Our results confirm previous experimental data and indicate that adhesion mechanisms supporting leukocyte-endothelium interaction may also be operative in human acute myocardial infarction.