الفهرس 
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Abstract
Adhesion molecules are a group of cel l surface molec u les, glycoproteins in nature, capable of
binding leukocyte and mediate leukocyte-endothelial interactions through specific
counter-receptors. They were classified into three mai n famil ies: selectins , Integri ns and
Immunoglobulin superfamilies.
sICAM-1 is a member of immunoglobulin superfamily. It is a cel l glycoprotein expressed on both
haemopoietic and non haemopoietic cells and is a cytokine-ind ucible adhesion molecule (Cronestein
et al, 1993).
CVD remains a leading cause of morbidity and mortal ity .It has been proved that inflammation plays
an important role in acute coronary syndromes, and adhesion molecules are critical mediators of the
inflammatory process. Soluble forms of these molecules are detectable i n serum and are elevated
acutely patients with unsta ble angina and AMI (Ercan et al , 2004).
Although reperfusion of occluded coronary artery should provide substantial benefits to pat
ients with A M I, however reperfusion itself can elicit adverse effects on the cardiac tissue,
which is called MI/RI. One important manifestation of MI/RI may be reperfusion arrhythmias (RAs),
wh ich may play a role i n sudden card iac death i n pat ients with CA D (Braunwald, 2002).sICAM-1 expression is enhanced on coronary endothel i um and
cardiomyocytes and contributes to leukocyte-i nduced tissue injury
(Lesperance et al , 2004).
The aim of th is study was to assess the l evel of circu lating slCAM-1 i n patients with AM I,
and to exami ne whether there may be a relationship between sICAM-1 level and frequency of RAs.
Our study was conducted in the Coronary Care Unit in Assi ut U n iversity Hospital between
May 2002 - July 2003,. It i ncl uded 33 patients with recent AMI who admitted within 6 hours from
onset of chest pain, whose ages ranged from 40-70 years, 20 males (60.6%)
and 13 females (39.4%) beside 10 age and sex matched healthy controls.
All participants in the study were submitted to full history taking including cigarette smoking,
and complete clinical exami nation stressing on manifestation of heart fai lure. Measurement
of weight i n
kg and height in cm body mass index according to (Edward et aL,1997).
The following investigation were performed:
1. Conventional investigations:
* Complete blood count before throm bolytic therapy and 24 hr after.
* Plain X-ray chest.
* Renal function tests (blood urea, serum creati n i ne ), l i ver funct ion tests.
* Lipid profile (total cholesterole, LDLc, HDLc, and TG)
* Random blood sugar.
* Cardiac enzymes (CK, LDH) on admission before strepokianse and 24 hrs later.
* Electrocard iogram, and continuos ECG monitoring.
* Echocardiographgy.
2. Specific laboratory investigation:
* Serum level of sICAM-1 was estimated by ELISA using Human soluble IACM-1 immunoassay, catalogue
n um ber BBE 1 B (USA).
The patients were classified into 2 groups:
group (A):
thrompolytic therapy.
Included 23 patients develop RAs after
group (B): Included I 0 patients who did not develop RAs
The results were compared between patients and controls, and between the two different patient
groups (group A, group B).
The results of our study can be summarized i n the followi ng:
1. The levels of slCAM-1 were significantly higher in patients with AMI than in controls.
2. The total leukocytic count was significantl y higher i n pat ients than in control.
3. There was significant positive correlation between per-therapy slCAM- l level and
smoking, total leukocytic count TG.
4. The pre-and post-thrombolytic levels of slCAM-1 were
significantly higher in patients with RAs (group A ) compared to that in group B.
5. The total leukocytic count pre-and post-throm bolytic therapy was significantly higher in group
A( RAs-rve) than i n group B( RAs-ve)
6. There was negative correlation between slCAM- l level and HDLc level.
7. Pre and post-throm bolytic CK level was sign ificantly h igher i n patients of group A than
that in patients in group B.
8. Increased incidence of RAs in patients with heart fai lure.
9. sl CA M-1 level increased significant ly (286.2 ± 8.7 vs 277.3 ± 2.6), (P < 0.500) in
patients with AMI who developed heart fai lure than in those who pass uncom plicated .
10. sl CAM-1 level and incidence of RAs increased sign i ficantly 111
extensive than in anterior and inferior AMI .
11. The levels of total cholesterol, LDLc, and TG were significantly h igher HDL were lower
i n patients than i n control group.