The relationship between the level of soluble CD40 ligand and angiographic extent and severity of coronary artery disease

Abstract

Objectives: Previous studies have suggested that atherosclerosis is a chronic inflammatory disease and implicate components of the immune system in atherogenesis. The CD40 and CD40 ligand system regulates multiple phases of the humoral and cellular immune response. Soluble CD40 (sCD40) ligand especially releases from activated platelets. Platelets are involved not only in thrombosis, but also in atherosclerotic lesion formation and restenosis processes. The aim of our study is to evaluate whether there is a relationship between the level of sCD40 ligand and angiographic extent and severity of coronary artery disease (CAD) and to compare other cardiovascular risk factors.Methods: 102 participants were included in our study. Among them, 37 patients constituted acute coronary syndrome (ACS) group, 41 patients were diagnosed as stable angina pectoris group (SAP), while 24 subjects served as control group. Peripheral venous blood samples were drawn at the Coronary Care Unit admission of ACS group patients. From SAP group patients and controls who have normal coronary arteries, blood samples collected after coronary angiography. The Gensini score was computed for each patient by assigning the severity score to each coronary stenosis in accordance with the degree of the vessel narrowing and its geographic importance.Results: Mean serum sCD40 ligand level was significantly higher in patients with ACS than the controls and SAP patients (p <0.001), there was no significant difference between SAP and control groups. Mean sCD40 ligand levels were not significantly different, when we compared ACS subgroups. Both in ACS and SAP patients, serum sCD40 ligand levels were not correlated with Gensini scores (p >0.05).Conclusion: Our study doesn't show relation between sCD40 ligand levels and Gensini scores in patients with different clinical sub-types of CAD. In ACS group sCD40 ligand levels were significantly higher than in other groups, but there was no significant difference between ACS sub-groups. This finding suggests that increased sCD40 ligand levels can be used as a marker for determining the unstable plaque before ruptured and occurring myocardial necrosis.