title: Levels and value of soluble P-selectin following acute myocardial infarction: evaluating the link between soluble P-selectin levels and recruitment of circulating white blood cells and the marker for the rapid diagnosis of chest pain.
abstract: BACKGROUND
  Platelet activation that results from coronary plaque rupture is important in the pathogenesis of acute myocardial infarction (AMI). Soluble p-selectin (sP-selectin) is crucial in modulating leukocyte adhesion to both platelets and endothelial cells during inflammatory response and thrombus formation. We hypothesized that sP-selectin, an index of both platelet activation and acute inflammation, rapidly increases and modulates the recruitment of circulating white blood cells (WBC) in patients following AMI.
  
  
  METHODS
  We conducted a prospective cohort study of 142 consecutive patients with ST-segment elevated AMI of onset < 12 h who were undergoing primary percutaneous coronary intervention. Blood samples for plasma levels of sP-selectin were obtained in the catheterization laboratory before coronary angiography was performed. The plasma levels of sP-selectin were also measured in 30 risk control subjects and 20 healthy control subjects.
  
  
  RESULTS
  The plasma level of sP-selectin and the circulating WBC count were significantly higher in patients with AMI than in either the risk control or healthy subjects (all of p values < 0.0001). Additionally, repeated measures of ANOVA demonstrated that there were no significant differences in plasma levels of sP-selectin (p > 0.10) in three intervals from the start of chest pain to blood sample collection (< 180 min, > or = 180 < 360, and > or = 360 < 720) following AMI. Correlation analysis demonstrated that the increase in the plasma level of sP-selectin was significantly related to the circulating WBC count (r = 0.248, p = 0.003).
  
  
  CONCLUSIONS
  sP-selectin was markedly elevated in an early phase of AMI. sP-selectin may be involved in modulating the recruitment of circulating WBC during AMI. These findings raise the need for a prospective investigation of sP-selectin as a potential reliable clinical tool for rapidly diagnosing AMI.
authors.affiliation: Division of Cardiology, Chang Gung Memorial Hospital, Kaohsiung, Taiwan.
authors.forename: Cheng-An
authors.initials: CA
authors.lastname: Chiu
authors.forename: Chiung-Jen
authors.initials: CJ
authors.lastname: Wu
authors.forename: Cheng-Hsu
authors.initials: CH
authors.lastname: Yang
authors.forename: Chih-Yuan
authors.initials: CY
authors.lastname: Fang
authors.forename: Yuan-Kai
authors.initials: YK
authors.lastname: Hsieh
authors.forename: Chi-Ling
authors.initials: CL
authors.lastname: Hang
authors.forename: Wei-Chin
authors.initials: WC
authors.lastname: Hung
authors.forename: Chien-Jen
authors.initials: CJ
authors.lastname: Chen
authors.forename: Shyh-Ming
authors.initials: SM
authors.lastname: Chen
authors.forename: Teng-Hung
authors.initials: TH
authors.lastname: Yu
authors.forename: Kuo-Ho
authors.initials: KH
authors.lastname: Yeh
authors.forename: Morgan
authors.initials: M
authors.lastname: Fu
authors.forename: Hon-Kan
authors.initials: HK
authors.lastname: Yip
mesh_terms: D000328:Adult; D000368:Aged; D015415:Biomarkers; D002637:Chest Pain / Q000175:diagnosis*; D015331:Cohort Studies; D005260:Female; D006801:Humans; D007958:Leukocyte Count; D007962:Leukocytes / Q000502:physiology; D008297:Male; D008875:Middle Aged; D009203:Myocardial Infarction / Q000097:blood*; D019007:P-Selectin / Q000097:blood; D011446:Prospective Studies
chemical_list: D015415:Biomarkers; D019007:P-Selectin