Aim To study clinical relationship of plasma adhesion molecule levels of coronary circulation in patients with acute coronary syndrome (ACS). Methods The plasma intercellular adhesion molecule-1 (ICAM-1) and vascular cell adhesion molecule-1 (VCAM-1) levels in the coronary sinus and aortic root were simultaneously examined in 30 patients with ACS, 35 patients with stable angina pectoris (SA) and 27 patients with control subjects. The plasma levels of ICAM-1 and VCAM-1 were measured by enzyme-linked immunosorbent assay. Results Both in the aortic root and the coronary sinus, the plasma ICAM-1 and VCAM-1 levels were significantly higher (p<0.05) in patients with ACS than in those with SA and in control subjects. The different plasma levels of adhesion molecules between coronary sinus and aortic root were significantly higher (p< 0.001) in patients with ACS than in those with SA and in control subjects. There were no significant differences in the values between in the coronary sinus and aortic root in patients with SA and control subjects. There were no significant relationship between plasma ICAM-1 and VCAM-1 levels and coronary lesion degree. Conclusions The plasma ICAM-1 and VCAM-1 levels were significantly higher in ACS. The changes of plasma ICAM-1 and VCAM-1 levels in coronary circulation reflect the severity of inflammation of coronary artery and may be related to plaque unstablity.