Elevation of the soluble thrombomodulin levels is associated with inflammation after percutaneous coronary interventions.
BACKGROUND
Thrombomodulin (TM) is an endothelial cell surface thrombin-binding protein with anticoagulation ability by thrombin-mediated activation of protein C. An increase of plasma soluble TM level is reported to be associated with severity and worse outcome of coronary artery disease.


OBJECTIVE
This prospective study investigated the relation of the elevated levels of plasma soluble TM and inflammatory and myonecrotic markers in patients undergoing percutaneous coronary intervention (PCI).


METHODS
Plasma levels of soluble TM, C-reactive protein (CRP), and creatine kinase and its MB isoenzyme were measured before and after PCI in 100 patients undergoing PCIs.


RESULTS
Peak TM levels after PCIs were significantly higher than baseline (3.39 +/- 1.63 vs. 2.90 +/- 1.57 ng/ml, p < 0.001). The peak TM levels after PCIs correlated significantly with the peak CRP and MB levels, and the maximal inflation duration (r = 0.423, p < 0.001; r = 0.212, p = 0.034; r = 0.307, p= 0.002, respectively).


CONCLUSIONS
Soluble TM levels increase significantly after PCI. The elevation of the soluble TM after PCI shows better correlation with inflammation than myocardial injury, indicating an endothelial origin. Measurement of soluble TM could be useful and calls for further studies on the prognostic effects of this marker in this clinical condition.
Chao
Ting-Hsing
TH
Department of Internal Medicine, College of Medicine, National Cheng Kung University, Tainan, Taiwan.
Li
Yi-Heng
YH
Tsai
Wei-Chuan
WC
Chen
Jyh-Hong
JH
Liu
Ping-Yen
PY
Tsai
Liang-Min
LM
D000368:Aged; D015906:Angioplasty, Balloon, Coronary; D015415:Biomarkers / Q000097:blood; D002097:C-Reactive Protein / Q000378:metabolism; D017023:Coronary Angiography; D003324:Coronary Artery Disease / Q000000981:diagnostic imaging / Q000378:metabolism* / Q000628:therapy*; D003402:Creatine Kinase / Q000378:metabolism; D052279:Creatine Kinase, MB Form; D005260:Female; D006801:Humans; D007527:Isoenzymes / Q000378:metabolism; D008297:Male; D008875:Middle Aged; D011446:Prospective Studies; D012995:Solubility; D013223:Statistics as Topic; D013624:Taiwan; D018180:Thrombomodulin / Q000378:metabolism*; D016896:Treatment Outcome
D015415:Biomarkers; D007527:Isoenzymes; D018180:Thrombomodulin; D002097:C-Reactive Protein; D003402:Creatine Kinase; D052279:Creatine Kinase, MB Form