Increased serum concentrations of Soluble CD40 Ligand as a prognostic marker in patients with Acute Coronary Syndrome |
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| Authors: | Priya Gururajan Prema Gurumurthy Pradeep Nayar Sai Babu A Sarasabharati Dolice Victor K M Cherian |
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| Institution: | (1) Department of Emergency Medicine, University of Massachusetts Medical School, 55 Lake Avenue North, Worcester, MA 01655, USA;(2) Department of Pediatrics, University of Massachusetts Medical School, Worcester, MA, USA;(3) Center for Platelet Function Studies, University of Massachusetts Medical School, Worcester, MA, USA;(4) Cardiovascular Research Institute, Wayne State University School of Medicine, Detroit, MI, USA |
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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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