1 Associate Professor of Immunology Shaheed Rajaie Cardiovascular Center

2 Associate Professor of Cardiology Shaheed Rajaie Cardiovascular Center.

3 Associate Professor of Cardiac Surgery Shaheed Rajaie Cardiovascular Center

4 G.P. Behsan Teb Azma Company.


Background: The results of studies on coronary artery disease risk factors have demonstrated that some adhesion molecules could be risk factors for coronary artery disease. ICAM-1 and VCAM-1 are the most important adhesion molecules. On the other hand, thrombomodulin is an anti inflammatory factor and can reduce the risk of coronary artery disease. In this study, as well as evaluating these factors, we also studied the effect of the interaction between these factors on coronary artery disease.
Methods: One hundred twenty-three patients between the ages of 45 and 70 years old who were admitted for coronary angiography in the cardiovascular center and met the inclusion criteria for the research, were selected in the first half of 2008. After recording their personal information and medical history in the questionnaires, blood samples were collected and after routine examination, the blood levels of these factors were measured. We then entered the acquired results of the blood examination and the angiography in the patient’s charts and analyzed the results using statistical methods.
Results: The angiography results in patients showed that 18 (14.7%) had normal coronary arteries, 5 (4%) had minimal coronary artery disease, 40 (32.5%) had single-vessel disease, 25 (20.3%) had two-vessel disease, and 35 (28.5%) had three-vessel disease. In laboratory tests, the mean soluble ICAM-1 level in patients with normal coronary arteries was 236 ngr/mL; 1 however, in patients with coronary artery disease, the mean level was 275 ngr/mL. The average amount of VCAM-1 in patients with normal coronary arteries was 697 ngr/mL, whereas patients with coronary artery disease had an average of 108 ngr/mL. Thrombomodulin in the normal coronary artery group was 42 ngr/mL, but in patients with coronary artery disease the average level was 30 ngr/mL.
Conclusion: The results in this research showed that increased levels of soluble ICAM-1 and also decreased levels of soluble thrombomodulin increased the risk and intensity of coronary artery disease, with statistical significance. The increase in soluble VCMA-1 also increased the risk of coronary artery disease; this was, however, not statistically significant. The important point is that increased levels of soluble ICAM-1 is a risk factor when the level of thrombomodulin is normal or below normal. When the levels of thrombomodulin and ICAM-1 have both increased, the increased risk and intensity of coronary artery disease is not statistically important.