Soluble CD40 ligand and interleukin-6 in the coronary circulation after acute myocardial infarction

BackgroundIn recent years there has been growing interest in the identification of novel biomarkers that may enable early exclusion of acute coronary syndromes (ACS) in the Emergency Department (ED). Soluble CD40 ligand (sCD40L) has been identified as a potential marker of coronary plaque destabilisation and platelet activation. We aimed to investigate the value of sCD40L measured at the time of ED presentation for enabling early diagnosis and exclusion of ACS.MethodsWe recruited patients presenting to the ED with suspected cardiac chest pain within the previous 24 h. We measured sCD40L in plasma samples taken at the point of ED presentation. All patients had troponin T measured at least 12 h after symptom onset and were followed up for 6 months for adverse events (death, acute myocardial infarction (AMI) or the need for urgent revascularisation).Results706 patients were recruited to the study. sCD40L levels were significantly lower in smokers, in patients with hyperlipidaemia or prior coronary revascularisation and in patients taking statins, r angiotensin-converting enzyme or calcium blockers. There was no significant difference in sCD40L levels between patients with (median 33.8ng/ml, IQR 18.0–80.5) and without (36.3 ng/ml, IQR 14.2–94.3) AMI (p=0.92) or between patients who did (34.0 ng/ml, 14.2–94.3) and who did not (34.9, 18.2–80.4) develop adverse events (p=0.82). The area under the Receiver Operating Characteristic curve was 0.50 (95% CI 0.45 to 0.56) for AMI and 0.49 (0.44–0.55) for adverse events. There was no trend towards increasing incidence of either outcome with ascending quintiles of sCD40L.ConclusionssCD40L is unhelpful in the ED diagnosis of ACS. Future work in this area should focus on other biomarkers.

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Changes of soluble CD40 ligand in the progression of acute myocardial infarction associate to endothelial nitric oxide synthase polymorphisms and vascular endothelial growth factor but not to platelet CD62P expression

Translational Research ◽

10.1016/j.trsl.2015.07.006 ◽

2015 ◽

Vol 166 (6) ◽

pp. 650-659 ◽

Cited By ~ 11

Author(s):

Patrícia Napoleão ◽

Maria do Céu Monteiro ◽

Luís B.P. Cabral ◽

Maria Begoña Criado ◽

Catarina Ramos ◽

...

Keyword(s):

Nitric Oxide ◽

Myocardial Infarction ◽

Acute Myocardial Infarction ◽

Endothelial Nitric Oxide Synthase ◽

Cd40 Ligand ◽

Vascular Endothelial ◽

Soluble Cd40 Ligand ◽

Oxide Synthase ◽

Endothelial Growth Factor ◽

Endothelial Nitric Oxide

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Lack of Association of Soluble CD40 Ligand with the Presence of Acute Myocardial Infarction or Ischemic Stroke in the Emergency Department

Clinical Chemistry ◽

10.1373/clinchem.2008.114231 ◽

2009 ◽

Vol 55 (1) ◽

pp. 175-178 ◽

Cited By ~ 9

Author(s):

Michaela Plaikner ◽

Andreas Peer ◽

Gerda Falkensammer ◽

Christoph Schmidauer ◽

Christoph Pechlaner ◽

...

Keyword(s):

Myocardial Infarction ◽

Acute Myocardial Infarction ◽

Emergency Department ◽

Ischemic Stroke ◽

Diagnostic Marker ◽

Linear Regression Analysis ◽

Cd40 Ligand ◽

Multiple Linear Regression Analysis ◽

Soluble Cd40 Ligand ◽

Reactive Protein

Abstract Background: Soluble CD40 ligand (sCD40L) has been proposed as a new risk marker for cardiovascular diseases; however, its possible role as a diagnostic marker in the emergency department (ED) has not yet been investigated. Methods: We investigated sCD40L for the diagnosis of acute myocardial infarction or ischemic stroke in 1089 consecutive patients (525 males, 564 females; age, 17–98 years; median, 56 years) in an ED treating mainly adults with medical or neurologic emergencies. We used a research assay from Roche Diagnostics to measure sCD40L in heparinized plasma prepared from routinely drawn blood samples. Results: Intraassay and interassay CVs in our laboratory ranged from 1.6%–4.2% and from 4.4%–4.9%, respectively. A multiple linear regression analysis revealed sCD40L concentration to be significantly associated with C-reactive protein concentration (P = 0.012) and platelet count (P < 0.001). In addition, a subgroup analysis revealed a significant association between smoking and sCD40L concentration (P = 0.006). All other tested variables, including discharge diagnosis, age, sex, and other laboratory variables, showed no significant associations. Conclusions: In adults presenting to the ED, sCD40L is not useful as a diagnostic marker for acute cardiac, cerebrovascular ischemic, or thromboembolic events.

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Plasma TAFI and soluble CD40 ligand do not predict reperfusion following thrombolysis for acute myocardial infarction

Thrombosis Research ◽

10.1016/j.thromres.2005.06.014 ◽

2006 ◽

Vol 118 (2) ◽

pp. 189-197 ◽

Cited By ~ 5

Author(s):

Nicholas L.M. Cruden ◽

Catriona Graham ◽

Scott A. Harding ◽

Christopher A. Ludlam ◽

Keith A.A. Fox ◽

...

Keyword(s):

Myocardial Infarction ◽

Acute Myocardial Infarction ◽

Cd40 Ligand ◽

Soluble Cd40 Ligand

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3724 Simvastatin decreases the levels of inflammatory cytokines (soluble CD40 ligand, tumour necrosis factor-alpha, interleukin-10) in acute myocardial infarction

European Heart Journal ◽

10.1016/s0195-668x(03)96276-2 ◽

2003 ◽

Vol 24 (5) ◽

pp. 724

Author(s):

W WOJAKOWSKI

Keyword(s):

Myocardial Infarction ◽

Acute Myocardial Infarction ◽

Tumour Necrosis ◽

Cd40 Ligand ◽

Interleukin 10 ◽

Tumour Necrosis Factor Alpha ◽

Soluble Cd40 Ligand ◽

Necrosis Factor Alpha ◽

Factor Alpha ◽

Necrosis Factor

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Biomarkers of acute myocardial infarction: diagnostic and prognostic value. Part 1 (literature review)

Clinical Practice ◽

10.17816/clinpract34284 ◽

2020 ◽

Author(s):

Aleksey Michailovich Chaulin ◽

Dmitry Viktorovich Duplyakov

Keyword(s):

Myocardial Infarction ◽

Acute Myocardial Infarction ◽

Growth Factor ◽

Prognostic Value ◽

Cd40 Ligand ◽

Cardiac Biomarkers ◽

Economic Damage ◽

Soluble Cd40 Ligand ◽

Fatty Acid Binding ◽

Diagnostic And Prognostic Value

Morbidity and mortality rates from acute myocardial infarction (AMI) have been growing rapidly in recent years, causing significant socio-economic damage. Cardiac biomarkers play an important role in the diagnosis and prediction of AMI. In our review article, we will summarize information about the main existing cardiac biomarkers and focus on their diagnostic and prognostic value for patients with AMI. In the first part of the review, we consider the diagnostic and prognostic value of biomarkers of necrosis and myocardial ischemia (aspartate aminotransferase; creatine phosphokinase; cardiac troponins; myoglobin, ischemia-modified albumin, fatty acid binding protein) and neuroendocrine AMI biomarkers (natriuretic peptides, adrenomedullin, catestatin, components of the renin-angiotensin-aldosterone system). In the second part of the review, we discuss the diagnostic and prognostic value of inflammatory AMI biomarkers (C-reactive protein, interleukin-6, tumor necrosis factor, myeloperoxidase, matrix metalloproteinases, soluble CD40 ligand form (sCD40L), procalcitonin, placental growth factor (PGF), procalcitonin) and recently discovered new biomarkers (microRNA, stimulating growth factor, expressed by genome 2 (ST2), growth differentiation factor 15 (GDF-15), galectin-3).

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