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Increased serum concentrations of Soluble CD40 Ligand as a prognostic marker in patients with Acute Coronary Syndrome

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Abstract

CD40-CD40L interaction plays a significant role in the pathogenesis of atherosclerosis and coronary artery disease. The clinical predictive value of Soluble CD40 Ligand (sCD40L) was evaluated in patients with Acute Coronary Syndrome (ACS) and Non-Cardiac Chest Pain (NCCP). The levels of serum soluble CD 40 ligand were measured by ELISA in 485 patients admitted to emergency care unit, of which 89 patients were diagnosed as NCCP. The levels of sCD40L were significantly increased in patients with ACS when compared to controls and NCCP. Receiver Operator Characteristic (ROC) Curve analysis showed sCD40L to be a good discriminator between patients with ischemic heart disease and patients without ischemic heart disease. The area under the curve was found to be 0.940 with 95% CI (0.915 to 0.960) (P<0.0001). The cut off value from the ROC curve was 2.99 ng/ml, above which sCD40L was considered to be positive. Combined assessment of sCD40L, Troponin I and CK-MB enhanced the risk prediction and early classification of patients. sCD40L seems to be a promising biomarker for identification and risk stratification for patients with acute coronary syndrome.

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References

  1. Henn V, Slupsky JR, Grafe M, Anagnostopoulos I, Forster R, Muller-Berghaus G, Kroczek RA. CD40 Ligand on activated platelets triggers an inflammatory reaction of endothelial cells. Nature 1998; 391: 591–594.

    Article  PubMed  CAS  Google Scholar 

  2. Aukrust P, Muller F, Ueland Thor BS, Berget T, Aaser E, Brunsvig BS, et al. Enhanced levels of soluble and membrane bound CD40 Ligand in platelets with unstable angina. Circulation 1999; 100: 614–620.

    PubMed  CAS  Google Scholar 

  3. Mach F, Schonbeck U, Libby P. CD 40 signaling in vascular cells: a key role in atherosclerosis? Atherosclerosis 1998; 137(suppl): s89–95.

    Article  PubMed  CAS  Google Scholar 

  4. de Lemos JA, Zirlik A, Schonbeck U, Varo N, Murphy SA, Kera A, et al. Associations between soluble CD40 Ligand, Atherosclerosis Risk Factors and Subclinical Atherosclerosis. Results from the Dallas Heart Study. Arteriosclerosis, Thromb Vascular biol 2005; 25: 2192–2196.

    Article  Google Scholar 

  5. Chai H, Yan S, Wang H, Zhang R, Lin PH, Yao Q, Chen C. CD 40 ligand increases expression of its receptor CD40 in human coronary artery endothelial cells. Surgery 2006; 140: 236–242.

    Article  PubMed  Google Scholar 

  6. Heeschen C, Dimmeler S, Hamm CW, van den Brand MJ, Boersma E, Zeiher AM, Simoons ML; CAPTURE Study Investigators. Soluble CD40 Ligand in acute coronary syndromes. N Engl J Med 2003; 348: 1104–1111.

    Article  PubMed  CAS  Google Scholar 

  7. Santilli F, Basili S, Ferroni P, Davi G. CD40/CD40L system and vascular disease. Inter Emerg Med 2007; 2: 256–268.

    Article  CAS  Google Scholar 

  8. Varo N, de Lemos J A, Libby P, Morrow DA, Murphy SA, Nuzzo R, et al. Soluble CD40L risk prediction after acute coronary syndromes. Circulation 2003; 108: 1049–1052.

    Article  PubMed  CAS  Google Scholar 

  9. Henn V, Steinbach S, Buchner K, Presek P, Kroczek RA. The inflammatory action of CD40 ligand expressed on activated human platelets is temporally limited by coexpressed CD40. Blood 2001; 98: 1047–1054.

    Article  PubMed  CAS  Google Scholar 

  10. Mach F, Schonbeck U, Bonnefoy JY, Pober JS, Libby P. Activation of monocyte/macrophage functions related to acute atheroma complication by ligation of CD40:Induction of collagenase stromyelysin and tissue factor. Circulation 1997; 96: 396–399.

    PubMed  CAS  Google Scholar 

  11. Miller DL, Yaron R, Yellin MJ. CD40L-CD40 interactions regulate endothelial cell surface tissue factor and thrombomodulin expression. J Leukoc Biol 1998; 63: 373–379.

    PubMed  CAS  Google Scholar 

  12. Michelson AD, Barnard MR, Krueger CA, Valeri CR, Furman MI. Circulating monocyte — platelet aggregates are a more sensitive marker of in vivo platelet activation than platelet surface P-Selectin: Studies in baboons, human coronary intervention and human acute myocardial infarction. Circulation 2001; 104: 1533–1537.

    Article  PubMed  CAS  Google Scholar 

  13. Yan J-C, Zhu J, Gao L, Wu ZG, Kong XT, et al. The effect of elevated serum soluble CD40 ligand on the prognostic value in patients with acute coronary syndrome. Clin Chim Acta 2004; 343: 155–159.

    Article  PubMed  CAS  Google Scholar 

  14. Weber M, Rabenau B, Stanisch M, Nef HM, Mollmann H, et al. Influence of sample type on soluble CD40 ligand assessment in patients with acute coronary syndromes. Thromb Res 2007; 120: 811–814.

    Article  PubMed  CAS  Google Scholar 

  15. Ahn RE, Lander G, Jy W, Bidot JC, Jimenez JJ, Horstman LL, Ahn SY. Differences of soluble CD40L in sera and plasma: Implications of CD40L as a marker of thrombotic risk. Thromb Res 2004; 114:143–148.

    Article  PubMed  CAS  Google Scholar 

  16. Tsuzuki M, Morishima I, Yoshida T, Hayashi Y, Miura M, Hirai T, et al. Inverse correlation between soluble CD40 ligand and soluble CD40 is absent in patients with unstable angina. Heart Vessels 2005; 20: 245–250.

    Article  PubMed  Google Scholar 

  17. Ivandic TB, Spanuth E, Hasse D, Lestin HG, Katus AH. Increased plasma concentrations of sCD40L in acute coronary syndrome depend on in vitro platelet activation. Clin Chem 2007; 53(7): 1231–1234.

    Article  PubMed  CAS  Google Scholar 

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Authors and Affiliations

  1. Department of Biochemistry, International Centre for Cardiothoracic and Vascular Diseases, Dr K.M Cherian Heart Foundation (A unit of Frontier LifeLine Pvt Ltd), Mogappair, Chennai, 101, India

    Priya Gururajan, Prema Gurumurthy, Sai Babu, A. Sarasabharati & Dolice Victor

  2. Department of Cardiology, International Centre for Cardiothoracic and Vascular Diseases, Dr K.M Cherian Heart Foundation (A unit of Frontier LifeLine Pvt Ltd), Mogappair, Chennai, 101, India

    Pradeep Nayar & K. M. Cherian

  3. International Centre for Cardio-Thoracic and Vascular Diseases, Dr K.M Cherian Heart Foundation (A unit of Frontier LifeLine Pvt Ltd), R-30 C, Ambattur Industrial Estate Road, Mogaippair, Chennai, 600 101, India

    Prema Gurumurthy

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  1. Priya Gururajan
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  2. Prema Gurumurthy
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Correspondence to Prema Gurumurthy.

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Gururajan, P., Gurumurthy, P., Nayar, P. et al. Increased serum concentrations of Soluble CD40 Ligand as a prognostic marker in patients with Acute Coronary Syndrome. Indian J Clin Biochem 24, 229–233 (2009). https://doi.org/10.1007/s12291-009-0043-9

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  • DOI: https://doi.org/10.1007/s12291-009-0043-9

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