Soluble CD40 Ligand in Aspirin-Treated Patients Undergoing Cardiac Catheterization

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 (AC...

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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
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description 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
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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&lt;0.05). sCD40L levels were similar in patients without and with the primary endpoint in the overall study population (p = 0.4). Likewise, sCD40L levels did not differ significantly between patients without and with the secondary endpoints (both p≥0.4). Similar results were obtained when only patients with angiographically-proven coronary artery disease (n = 459), stent implantation (n = 205) or ACS (n = 125) were analyzed. The adjustment for differences in patient characteristics by multivariate regression analyses did not change the results. ROC curve analyses did not reveal cut-off values for sCD40L for the prediction of the primary or secondary endpoints. 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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&lt;0.05). sCD40L levels were similar in patients without and with the primary endpoint in the overall study population (p = 0.4). Likewise, sCD40L levels did not differ significantly between patients without and with the secondary endpoints (both p≥0.4). Similar results were obtained when only patients with angiographically-proven coronary artery disease (n = 459), stent implantation (n = 205) or ACS (n = 125) were analyzed. The adjustment for differences in patient characteristics by multivariate regression analyses did not change the results. ROC curve analyses did not reveal cut-off values for sCD40L for the prediction of the primary or secondary endpoints. 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Frelinger, 3rd, Andrew L ; Michelson, Alan D</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c758t-4ec06445280316a7e4cd0d29c685312020213ffe3c005dd07cffe5b593eecac53</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2015</creationdate><topic>Acute coronary syndrome</topic><topic>Acute coronary syndromes</topic><topic>Analysis</topic><topic>Aspirin</topic><topic>Aspirin - therapeutic use</topic><topic>Blood platelets</topic><topic>C-reactive protein</topic><topic>Cancer</topic><topic>Cardiac Catheterization</topic><topic>Cardiovascular disease</topic><topic>Cardiovascular diseases</topic><topic>Cardiovascular Diseases - blood</topic><topic>Cardiovascular Diseases - diagnosis</topic><topic>Cardiovascular Diseases - drug therapy</topic><topic>Catheterization</topic><topic>CD40 antigen</topic><topic>CD40 Ligand - blood</topic><topic>CD40L protein</topic><topic>Chlorophyll</topic><topic>Clinical outcomes</topic><topic>Clopidogrel</topic><topic>Complications and side effects</topic><topic>Coronary artery</topic><topic>Coronary artery disease</topic><topic>Coronary vessels</topic><topic>Diabetes</topic><topic>Dosage and administration</topic><topic>Drug therapy</topic><topic>Enzyme-linked immunosorbent assay</topic><topic>Female</topic><topic>Health risks</topic><topic>Heart</topic><topic>Heart catheterization</topic><topic>Heart diseases</topic><topic>Hematocrit</topic><topic>Hematology</topic><topic>Hospitals</topic><topic>Humans</topic><topic>Hypertension</topic><topic>Implantation</topic><topic>Implants</topic><topic>Intubation</topic><topic>Ischemia</topic><topic>Ligands</topic><topic>Male</topic><topic>Medical imaging</topic><topic>Medical records</topic><topic>Medical schools</topic><topic>Middle Aged</topic><topic>Oncology</topic><topic>P-selectin</topic><topic>Patients</topic><topic>Physiological aspects</topic><topic>Platelet Aggregation Inhibitors - therapeutic use</topic><topic>Platelets</topic><topic>Population studies</topic><topic>Predictions</topic><topic>Proteins</topic><topic>Regression analysis</topic><topic>Studies</topic><topic>Surgical implants</topic><topic>Therapy</topic><topic>Ticlopidine - analogs &amp; 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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&lt;0.05). sCD40L levels were similar in patients without and with the primary endpoint in the overall study population (p = 0.4). Likewise, sCD40L levels did not differ significantly between patients without and with the secondary endpoints (both p≥0.4). Similar results were obtained when only patients with angiographically-proven coronary artery disease (n = 459), stent implantation (n = 205) or ACS (n = 125) were analyzed. The adjustment for differences in patient characteristics by multivariate regression analyses did not change the results. ROC curve analyses did not reveal cut-off values for sCD40L for the prediction of the primary or secondary endpoints. In conclusion, plasma sCD40L levels are reduced by antiplatelet therapy with clopidogrel, but not associated with long-term ischemic outcomes in unselected consecutive aspirin-treated patients undergoing cardiac catheterization.</abstract><cop>United States</cop><pub>Public Library of Science</pub><pmid>26237513</pmid><doi>10.1371/journal.pone.0134599</doi><oa>free_for_read</oa></addata></record>
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1932-6203
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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
title Soluble CD40 Ligand in Aspirin-Treated Patients Undergoing Cardiac Catheterization
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