The endothelial leukocyte adhesion molecule. Role in coronary artery disease

Objectives - It is hypothesized that adhesion molecules could be an early predictor of coronary artery disease. The endothelial leucocyte adhesion molecule (ELAM) is expressed on activated endothelial cells only and it has been found to exist in a soluble form. This soluble form (sELAM) may be an important marker for endothelial cell damage. The aim of the present study was to compare the sELAM levels in coronary artery disease (CAD) subjects and healthy controls and to evaluate their clinical usefulness. Methods and results - sELAM were measured using enzyme immunoassay methods in 145 subjects having angiographically determined CAD and compared with 70 healthy, normotensive controls having a normal stress test/angiogram. Significantly higher values (p < 0.0001) were observed in CAD subjects as compared to controls.Also, subjects who underwent angioplasty and were later on readmitted with restenosis within I year had significantly higher levels of sELAM as compared to those who did not get restenosis within a year. Conclusions -These findings show that sELAM concentration is elevated in the presence of CAD and is useful for determining the presence of coronary atherosclerosis. An increased level of sELAM in patients susceptible to restenosis supports a role for white blood cell/endothelial interaction in restenosis after angioplasty.