From the Division of Cardiology, Chang Gung Memorial Hospital, Kaohsiung; Department of Biological Sciences, 1 National Sun Yat-Sen University, Kaohsiung. Received: Feb. 23, 2005; Accepted: Jul. 21, 2005 Address for reprints: Dr. Hon-Kan Yip, Division of Cardiology, Department of Internal Medicine Chang Gung Memorial Hospital, No. 123, Dabi Rd., Niausung Shiang, Kaohsiung, Taiwan 833, R.O.C. Tel: 886-7-7317123; Fax: 886-7-7322402; E-mail: tang@adm.cgmh.org.tw 613 Original Article Circulating Levels of Soluble P-Selectin in Patients in the Early and Recent Phases of Myocardial Infarction Wen-Hao Liu, MD; Cheng-Hsu Yang, MD; Kuo-Ho Yeh, MD; Hsueh-Wen Chang 1 , PhD; Yen-Hsun Chen, MD; Shyh-Ming Chen, MD; Cheng-I Cheng, MD; Chien-Jen Chen, MD; Teng-Hung Yu, MD; Wei-Chin Hung, MD; Chi-Ling Hang, MD; Chiung-Jen Wu, MD; Hon-Kan Yip, MD Background: Circulating soluble P-selectin (sP-selectin), a biomarker of platelet activation is substantially increased in patients with acute myocardial infarction (AMI). However, the circulating level of sP-selectin in patients in the early (onset of AMI > 12 h but ≤ 7 d) or recent (onset of AMI ≥ 8 d but ≤ 21 d) phase after AMI remains unclear. The purpose of this study was to prospectively evalu- ate whether the circulating level of sP-selectin remains elevated in these two consecutive phases after an AMI. Methods: Blood samples were collected in the catherization room before coronary angiography to assess the circulating level of sP-selectin. A total of 53 con- secutive patients, 34 with early MI (group 1) and 19 with recent MI (group 2), who had had no prior thrombolytic therapy were included. Circulating levels of sP-selectin were also measured in 30 risk control (stable angina) subjects undergoing elective percutaneous coronary intervention and in 20 healthy subjects who comprised the healthy control group. Results: The circulating level of sP-selectin did not differ between patients with early AMI and those with recent MI (p = 0.632). However, the plasma level of sP- selectin was significantly higher in group 1 and 2 patients than in the risk control and healthy control subjects (all p values < 0.0001). Conclusions: Circulating sP-selectin was elevated in patients 12 hours to 7 days after AMI and the elevation was maintained until 21 days after AMI. Therefore, investi- gation of longer utilization of anti-platelet and anti-inflammatory agents for patients following AMI might be worthwhile. (Chang Gung Med J 2005;28:613-20) Key words: Soluble P-selectin, early or recent myocardial infarction. N umerous studies have indicated that the acute inflammatory response, as evoked by the cellu- lar interaction of platelets, leukocytes and endotheli- um, plays a pivotal role in thrombus formation. (1,2) This process subsequently leads to development of acute coronary syndromes. (1) Other studies have demonstrated that endothelial adhesion molecules and human P-selectin mediate granulocyte binding to