Elevated plasma levels of soluble P-selectin in patients with acute myocardial infarction and unstable angina. An inverse link to lipoprotein(a).

P-selectin in platelets and endothelial cells mediates adhesive interactions between platelet, leukocyte and endothelium to form thrombi. The purpose of the present study was to investigate the plasma level of soluble P-selectin (sP-selectin) in patients with coronary heart disease and the relationship between sP-selectin and plasma concentration of lipoprotein(a) [Lp(a)]. Levels of sP-selectin and Lp(a) were determined by enzyme-linked immunoabsorbent assay on plasma taken from patients with acute myocardial infarction (AMI), old myocardial infarction (OMI), unstable angina (UA), stable angina (SA) and the controls. In patients with AMI and UA, sP-selectin levels (79.62+/-3.82 ng/ml, 43.75+/-2.97 ng/ml, respectively) were significantly higher (P<0.01) than those in patients with OMI (15.92+/-1.34 ng/ml), SA (15.31+/-1.51 ng/ml), and the controls (14.93+/-1.33 ng/ml), but there was no difference between AMI and UA groups. Among all subjects studied, there was an inverse correlation between Lp(a) and sP-selectin (r=-0.315 P<0.001). These findings indicate that plasma levels of sP-selectin are increased in patients with AMI and UA, and high levels of soluble P-selectin may play a role in the pathogenesis of acute coronary events.