Background: Adhesion molecules have been suggested as mediators of atherosclerotic inflammatory process. They may contribute to the pathogenesis of stable and unstable angina and acute coronary syndromes. It is also known that the extent of myocardial damage contributes to the elevation of serum vascular endothelial growth factor (sVEGF). We hypothesized that soluble forms of cellular adhesion molecules (CAMs) and sVEGF may be useful biochemical markers for the follow-up of patients during an acute coronary syndrome. Methods: The study group consisted of 63 patients with coronary artery disease: 36 patients with unstable angina (UA), 27 patients with acute myocardial infarction (AMI) and 30 healthy persons acted as controls. Serum levels of soluble Intercellular Adhesion Molecule 1 (sICAM-1), Vascular Cell Adhesion Molecule 1 (sVCAM-1), sE-selectin, and also soluble Vascular Endothelial Growth Factor (sVEGF) were measured at 1st and 4th day following admission. Results: In patients with UA and AMI , serum sE-selectin, sICAM-1 and sVCAM-1 levels during admission were higher when compared to those found in controls. The levels of the soluble molecules sICAM-1 and sVCAM-1 remained elevated at the 4th day following admission. The levels of sVEGF were increased during the 1st day of admission in patients with UA and during the 4th day following admission in patients with AMI. Conclusions: These findings support the pathogenic role of inflammation in UA and MI and indicate that the inflammatory response is sustained for at least 72 hours after acute presentation. The decrease of sVEGF in patients with UA may reflect the uncomplicated course of these patients and may be used as a risk stratification marker in patients with ACS. The mechanisms which are responsible for the disturbance of the microcirculation in myocardial ischaemia are not fully understood. The study of cell activation may serve as a key to develop a systematic model of vascular disease.