Vascular cell adhesion molecule-1 and intercellular adhesion molecule-1 serum level in patients with chest pain and normal coronary arteries (syndrome X)

Background: Plasma levels of soluble vascular cell adhesion molecule-1 (VCAM-1) and intercellular adhesion molecule-1 (ICAM-1) mediators of leukocyte adhesion to vascular endothelium may implicate in the pathogenesis of the syndrome of chest pain with normal coronary arteries. Hypothesis: We attempted tb determine whether markers of endothelial activation are raised in patients with chest pain and normal coronary arteries. Methods: We measured plasma VCAM-1, ICAM-1 (ng/ml) in 36 patients (34 men, 2 women, aged 62 +/- 9 years) with stable angina, coronary artery disease (CAD), and a positive response to exercise test; in 21 patients (6 men, 15 women, aged 56 +/- 9 years) with chest pain and normal coronary arteriograms (syndrome X); and in 11 healthy control subjects (8 men, 3 women, aged 49 +/- 14 years). Results: Plasma ICAM-1 levels were significantly higher both in patients with CAD (mean +/- standard error of the mean) (328 +/- 26, p<0.05), and in syndrome X (362 <plus/minus> 22, p<0.01) than in controls (225 <plus/minus> 29). VCAM-1 levels were also higher in syndrome X (656 +/- 41 ng/ml) and in patients with CAD (626 +/- 32 ng/ml) than in controls (551 +/- 60, p=0.09). Conclusions: ICAM-1 and VCAM-1 levels are increased both in patients with CAD and with syndrome X compared with control individuals. These findings may suggest the presence of chronic, inflammation with involvement of the endothelium in patients with anginal chest pain and normal coronary angiograms.