Adhesion Molecules in Assessment of Annual Prognosis in Young Patients with Acute Coronary Syndrome

Aim. To study the place and role of adhesive molecules (E-, L-, P-selectins, intercellular and vascular adhesion molecules of type 1 — ICAM-1, VCAM-1) in development of unfavorable one-year prognosis in young patients with acute coronary syndrome (ACS). Material and methods. A 12-month prospective follow-up included 95 patients (90 men, 5 women, mean age 41.00 [39.00-43.00] years) with ACS who underwent percutaneous coronary intervention (PCI). The endpoints were evaluated (primary — cardiovascular death, and combined secondary — nonfatal acute myocardial infarction and acute cerebrovascular accident, emergency hospitalization due to cardiovascular causes — unstable angina, arrhythmias, heart failure). Blood concentrations of E-, L-, P-selectins, ICAM-1, VCAM-1 were determined by enzyme immunoassay on the 1st (before PCI) and on the 7th day of hospitalization (after PCI). Results. During 12 months, 22 (23.16 %) patients had estimated endpoints: death in 2 (2.1 %) patients, nonfatal myocardial infarction in 6 (6.32 %), hospitalization due to unstable angina in 14 (14.73 %). In ACS patients with unfavorable annual prognosis, the levels of leukocytes, P-selectin and ICAM-1 on day 1 (before PCI), L- and P-selectins on day 7 (after PCI) were significantly higher than in patients with favorable annual period. According to multivariate analysis, predictors of unfavorable annual prognosis in young ACS patients were the levels of leukocytes (p=0.020) and ICAM-1 (p=0.010) on day 1 (before PCI) and L-selectin on day 7 after PCI (p=0.040). Conclusion. During the first 12 months in young ACS patients the most significant factors of unfavorable prognosis are the levels of blood leukocytes and ICAM-1 on day 1 (before PCI), and L-selectin on the 7th day after percutaneous coronary intervention.