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.
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.
Chiu
Cheng-An
CA
Division of Cardiology, Chang Gung Memorial Hospital, Kaohsiung, Taiwan.
Wu
Chiung-Jen
CJ
Yang
Cheng-Hsu
CH
Fang
Chih-Yuan
CY
Hsieh
Yuan-Kai
YK
Hang
Chi-Ling
CL
Hung
Wei-Chin
WC
Chen
Chien-Jen
CJ
Chen
Shyh-Ming
SM
Yu
Teng-Hung
TH
Yeh
Kuo-Ho
KH
Fu
Morgan
M
Yip
Hon-Kan
HK
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
D015415:Biomarkers; D019007:P-Selectin