Circulating endothelial cell count, plasma vWF and soluble ICAM-1 levels following primary or elective percutaneous coronary intervention

BackgroundPercutaneous coronary intervention (PCI) is an important therapeutic strategy in patients with ischaemic heart disease. Our aim was to clarify the extent of endothelial injury induced by PCI in stable angina (SA) or in acute ST-elevation myocardial infarction (STEMI).MethodsCirculating endothelial cell (CEC) count, von Willebrand factor (vWF) and soluble intercellular adhesion molecule-1 (sICAM-1) levels were determined pre-, post-, 24 and 96 h after PCI in patients with SA (n = 23) and with STEMI (n = 28). To provide control data regarding the effect of angiography itself stable angina patients with coronarography only (n = 23) were enrolled.ResultsPCI and coronarography in stable angina patients caused measurable, but only non-significant elevation of CEC count and plasma vWF (p = NS). In STEMI, significantly higher baseline CEC count (p = 0.019) and vWF plasma levels (p = 0.046) were found compared to SA with PCI/or coronarography. After PCI, explicit increase in CEC count was observed (significant peak at 24 h) (p = 0.036). Positive correlation was found between baseline CKMB and CEC count at 24 h (r = 0.51, p < 0.05).ConclusionBoth coronary angiography and elective PCI cause only mild endothelial injury. However, in patients with STEMI, not only the procedure itself but myocardial ischemia and the ongoing atherothrombotic process might be responsible for the prolonged and more pronounced endothelial damage.