Soluble CD40 Ligand in Aspirin-Treated Patients Undergoing Cardiac Catheterization

• Published in: PloS one 2015-08, Vol.10 (8), p.e0134599-e0134599
• Main Authors: Gremmel, Thomas, Frelinger, 3rd, Andrew L, Michelson, Alan D
• Format: Article
• Language: English
• Subjects: Acute coronary syndrome; Acute coronary syndromes; Analysis; Aspirin; Aspirin - therapeutic use; Blood platelets; C-reactive protein; Cancer; Cardiac Catheterization; Cardiovascular disease; Cardiovascular diseases; Cardiovascular Diseases - blood; Cardiovascular Diseases - diagnosis; Cardiovascular Diseases - drug therapy; Catheterization; CD40 antigen; CD40 Ligand - blood; CD40L protein; Chlorophyll; Clinical outcomes; Clopidogrel; Complications and side effects; Coronary artery; Coronary artery disease; Coronary vessels; Diabetes; Dosage and administration; Drug therapy; Enzyme-linked immunosorbent assay; Female; Health risks; Heart; Heart catheterization; Heart diseases; Hematocrit; Hematology; Hospitals; Humans; Hypertension; Implantation; Implants; Intubation; Ischemia; Ligands; Male; Medical imaging; Medical records; Medical schools; Middle Aged; Oncology; P-selectin; Patients; Physiological aspects; Platelet Aggregation Inhibitors - therapeutic use; Platelets; Population studies; Predictions; Proteins; Regression analysis; Studies; Surgical implants; Therapy; Ticlopidine - analogs & derivatives; Ticlopidine - therapeutic use
• ISSN: 1932-6203; 1932-6203
• DOI: 10.1371/journal.pone.0134599

Plasma soluble CD40 ligand (sCD40L) is mainly generated by cleavage of CD40L from the surface of activated platelets, and therefore considered a platelet activation marker. Although the predictive value of sCD40L for ischemic events has been demonstrated in patients with acute coronary syndromes (ACS), studies on the association of sCD40L with cardiovascular outcomes in lower risk populations yielded heterogeneous results. We therefore sought to investigate factors influencing sCD40L levels, and the predictive value of sCD40L for long-term ischemic events in unselected, aspirin-treated patients undergoing cardiac catheterization. sCD40L was determined by a commercially available enzyme-linked immunosorbent assay in 682 consecutive patients undergoing cardiac catheterization. Two-year follow-up data were obtained from 562 patients. Dual antiplatelet therapy with aspirin and clopidogrel was associated with significantly lower levels of sCD40L and lower platelet surface expressions of P-selectin and activated GPIIb/IIIa compared to aspirin monotherapy (all p≤0.01). Hypertension was linked to lower plasma concentrations of sCD40L, whereas female sex, increasing high-sensitivity C-reactive protein, and hematocrit were associated with higher sCD40L concentrations (all p