Role of E- selectin in coronary artery disease

ABSTRACT

Our present study was designed to evaluate the role of circulating E-selectin as a marker of endothelial dysfunction in coronary artery disease [CAD] and to answer the question [Is E-selectin considered one of the acute phase reactants in acute coronary syndrome or not?]. Fifty-six patients with CAD [thirteen cases had stable angina pectoris [SAP]; twenty-two cases had unstable angina [UA] and twenty one cases had acute myocardial infarction [AMI] were included in this study compared with ten healthy normal persons as control groups [NC]. All patients and control group were subjected to the following [full medical history, clinical examination; resting [ECG]; two dimensional echo-cardiographic Doppler examination and coronary angiography [where CAD was considered when one or more of epicardial coronary vessels was stenosed >/= 50% E-selectin was evaluated once for all patients except for those of AMI the evaluation of E-selectin was done twice [at admission and after 24 hours of admission]. Total serum cholesterol [TC], serum triglyceride [TG], LDL-cholesterol, HDL-cholesterol, and random blood sugar [RBS] were evaluated for all patients. A highly significant levels of E-selectin were obtained when E-selectin level in AMI group was compared to NC group [P<0.01]. UA group showed a significant comparative results with NC group [P<0.05]; while no significant results when E-selectin in SAP group was compared to NC group. E-selectin show significant statistical difference when comparison was done between AMI group and UA [P<0.05], and between AMI and SAP [P<0.01] and between UA and SAP [P<0.05]. E-selectin did not show a statistical difference when comparison was made in AMI group at admission and 24 hs later.No direct relation between E-selectine and other risk factors TC, TG, HDL-C, LDL-C, RBS, but there is parallel relation between E-selectin and TC, TG, HDL-C. E-selectin is significantly elevated in AMI and UA [compared to SAP group and NC group]; so it is suggested to be used in the future as a useful marker for the diagnosis of AMI and UA but not for SAP [i.e. as acute phase reactant in acute coronary syndrome]. E-selectin may be used as a diagnostic tool to differentiate between UA and SAP