Syndrome X was associated with significantly higher plasma ICAM-1 levels compared to healthy controls (362 vs 225 ng/ml; p<0.01), suggesting chronic inflammation with endothelial involvement.
Observational (n=68)
Are plasma levels of endothelial activation markers (VCAM-1 and ICAM-1) elevated in patients with chest pain and normal coronary arteries (syndrome X) compared to healthy controls?
Elevated levels of ICAM-1 and VCAM-1 in patients with syndrome X suggest that chronic endothelial inflammation plays a role in the pathogenesis of anginal chest pain with normal coronary arteries.
Absolute Event Rate: 362% vs 225%
p-value: p=<0.01
BACKGROUND: Plasma levels of soluble vascular cell adhesion molecule-1 (VCAM-1) and intercellular adhesion molecule-1 (ICAM-1) mediators of leukocyte adhesion to vascular endothelium may implicate in the pathogenesis of the syndrome of chest pain with normal coronary arteries. HYPOTHESIS: We attempted to determine whether markers of endothelial activation are raised in patients with chest pain and normal coronary arteries. METHODS: We measured plasma VCAM-1, ICAM-1 (ng/ ml) in 36 patients (34 men, 2 women, aged 62 +/- 9 years) with stable angina, coronary artery disease (CAD), and a positive response to exercise test; in 21 patients (6 men, 15 women, aged 56 +/- 9 years) with chest pain and normal coronary arteriograms (syndrome X); and in 11 healthy control subjects (8 men, 3 women, aged 49 +/- 14 years). RESULTS: Plasma ICAM-1 levels were significantly higher both in patients with CAD (mean +/- standard error of the mean) (328 +/- 26, p < 0.05), and in syndrome X (362 +/- 22, p < 0.01) than in controls (225 +/- 29). VCAM-1 levels were also higher in syndrome X (656 +/- 42 ng/ml) and in patients with CAD (626 +/- 42 ng/ml) than in controls (551 +/- 60, p = 0.09). CONCLUSIONS: ICAM-1 and VCAM-1 levels are increased both in patients with CAD and with syndrome X compared with control individuals. These findings may suggest the presence of chronic inflammation with involvement of the endothelium in patients with anginal chest pain and normal coronary angiograms.
Tousoulis et al. (2001) conducted an observational in Chest pain with normal coronary arteries (syndrome X) (n=68). Syndrome X (chest pain with normal coronary arteries) vs. Healthy controls was evaluated on Plasma ICAM-1 levels (ng/ml) (p=<0.01). Syndrome X was associated with significantly higher plasma ICAM-1 levels compared to healthy controls (362 vs 225 ng/ml; p<0.01), suggesting chronic inflammation with endothelial involvement.