Relationship between myocardial injury and soluble P-selectin in non-ST elevation acute coronary syndromes

Abstract

Background The relationships among troponin concentration, early phase coagulation activation and soluble P-selectin concentration was evaluated in this study. Methods and Results Troponin-1, soluble P-selectin, von Willebrand factor (vWF), fibrinogen, plasminogen, plasminogen activator inhibitor 1 (PAI-1) and tissue plasminogen activator (t-PA) concentrations of 202 consecutive patients with non-ST elevation acute coronary syndrome (NSTE-ACS) were measured at the time of admission. Patients were classified into 2 groups as troponin-negative (< 0.2ng/ml, n=129) or positive (>= 0.2 ng/rnl, n=73). Soluble P-selectin concentrations were found to be higher (p < 0.001) and correlated with troponin concentrations (r=0.313, p < 0.005) in troponin-positive patients with NSTE-ACS. In these patients fibrinogen (p < 0.001), plasminogen (p < 0.001) and PAI-1 (p < 0.026) concentrations were higher and t-PA concentrations were lower (p < 0.013) and all these parameters correlated with P-selectin concentrations (p < 0.001). There was no difference between the groups according to vWF concentrations (p=0.379). Soluble P-selectin concentrations were found to be an independent predictor of troponin positivity (beta=0.295, odds ratio=1.05, p < 0.001). Analysis of regression revealed a significant effect of troponin on soluble P-selectin concentrations (r=0.52, r2=0.27, p < 0.001). Conclusions The results suggest that higher soluble P-selectin concentrations might be involved in increased coagulation activation and myocardial injury development in patients with NSTE-ACS.