Plasma soluble adhesion molecules; intercellular adhesion molecule-1, vascular cell adhesion molecule-1 and E-selectin levels in patients with isolated coronary artery ectasia.

摘要

Plasma soluble adhesion molecules, intercellular adhesion molecule-1 (ICAM)-1, vascular cell adhesion molecule-1 (VCAM-1) and E-selectin leves of patients with isolated coronary artery ectasia (CAE), patients with obstructive coronary artery disease without CAE and subjects with angiographically normal coronary arteries were evaluated. Patients with isolated CAE were detected to have significantly higher levels of plasma soluble ICAM-1, VCAM-1 and E-selectin in comparison with patients with obstructive coronary artery disease without CAE (ICAM, 673+/-153 versus 381+/-106, respectively, P<0.001; VCAM-1, 2366+/-925 versus 1136+/-208, respectively, P<0.001; E-selectin, 74+/-21 versus 61+/-18, respectively, P=0.01) and subjects with normal coronary arteries (ICAM-1, 673+/-153 versus 303+/-131, respectively, P<0.001; VCAM-1, 2366+/-925 versus 729+/-231, respectively, P<0.001; E-selectin, 74+/-21 versus 49+/-9, respectively, P<0.001), suggesting the presence of a more severe and extensive chronic inflammation in the coronary circulation in patients with isolated CAE. BACKGROUND: The common coexistence of coronary artery ectasia (CAE) with coronary artery disease (CAD) suggests that it may be a variant of CAD. However, it is not clear why some patients with obstructive CAD develop CAE whereas most do not. Inflammation has been reported to be a major contributing factor to both obstructive and aneurysmatic vascular disorders and therefore, in the present study, the plasma soluble adhesion molecules, intercellular adhesion molecule-1 (ICAM-1), vascular cell adhesion molecule-1 (VCAM-1) and E-selectin levels in isolated CAE were investigated. METHODS: The study population consisted of three groups: the first consisted of 32 patients with isolated CAE without stenotic lesion; the second of 32 patients with obstructive CAD without CAE; and the third group of 30 control subjects with normal coronary arteries. Coronary diameters were measured as the maximum diameter of the ectasic segment by use of a computerized quantitative coronary angiography analysis system. According to the angiographic definition used in the Coronary Artery Surgery Study, a vessel is considered to be ectasic when its diameter is >/=1.5 times that of the adjacent normal segment in segmental ectasia. Plasma soluble ICAM-1, VCAM-1 and E-selectin levels were measured in all patients and control subjects using commercially available enzyme-linked immunosorbent assay kits. RESULTS: Patients with isolated CAE were found to have significantly higher levels of plasma soluble ICAM-1, VCAM-1, and E-selectin in comparison with patients with obstructive CAD without CAE (ICAM, 673+/-153 versus 381+/-106, respectively; P<0.001; VCAM-1, 2366+/-925 versus 1136+/-208, respectively; P<0.001; E-selectin, 74+/-21 versus 61+/-18, respectively; P=0.01) and control subjects with normal coronary arteries (ICAM-1, 673+/-153 versus 303+/-131, respectively;, P<0.001; VCAM-1, 2366+/-925 versus 729+/-231, respectively; P<0.001; E-selectin, 74+/-21 versus 49+/-9, respectively; P<0.001). In addition, we detected statistically significant positive correlation between the total length of ectasic segments and the levels of plasma soluble ICAM-1 (r=0.625; P<0.001), VCAM-1 (r=0.548; P=0.001) and E-selectin (r=0.390; P=0.027). Multivariate logistic regression analysis revealed a significant independent relation between isolated CAE and ICAM-1 [odds ratio (OR)=1.023; 95% confidence interval (CI)=1.0048-1.0414; P=0.0129] and VCAM-1 (OR=1.0057; 95% CI=1.0007-1.0106; P=0.0240). CONCLUSIONS: We have shown that patients with isolated CAE have raised levels of plasma soluble ICAM-1, VCAM-1 and E-selectin in comparison with patients with obstructive CAD without CAE and control subjects with normal coronary arteries, suggesting the presence of a more severe and extensive chronic inflammation in the coronary circulation in these patients.