Abstract
Background
Recent studies indicated that local inflammation played a pivotal role in the pathogenesis of coronary heart disease. Soluble CD40 ligand (sCD40L) and hsC‐ reactive protein (hsCRP) are important inflammatory mediators. However, whether they can reflect local coronary inflammation is unclear.
Hypothesis
We hypothesized that transcoronary concentration gradient of sCD40L could reflect local inflammation in patients with coronary heart disease (CHD) more reliably.
Methods
Forty subjects were divided into unstable angina pectoris (UAP) group (n = 20), stable angina pectoris (SAP) group (n = 10), and controls (n = 10). Blood samples were collected from the coronary sinus (CS), aortic root (AO), and femoral vein (FV). The coronary circulation was expressed as CS‐AO difference, while system circulation was expressed as FV‐AO difference. sCD40L and hs‐CRP were measured.
Results
Complex lesions were more frequent in the UAP group than in the SAP group (85% vs. 40%, p < 0.05). CS‐AO differences of sCD40L were much greater in the UAP group than in the SAP or control groups, and were greatly higher than FV‐AO difference in UAP group (465.49 ± 247.85 pg/mL vs. −14.94 ± 83.41 pg/mL; 465.49 ± 247.85 pg/mL vs. −7.66 ± 78.54 pg/mL; 465.49 ± 247.85 pg/mL vs. −7.99 ± 141.34 pg/mL, all p < 0.001). CS‐AO differences of sCD40L were higher in patients with complex lesions than with smooth lesions (657.86 ± 384.76 pg/mL vs. 317.62 ± 409.98 pg/mL, p < 0.01). There were no significant differences of CS‐AO in hs‐CRP among the three groups.
Conclusions
In patients with CHD, the transcoronary concentration gradient of sCD40L is more sensitive than hsCRP, and sCD40L possibly a better marker of local inflammtion and plaque instability. Copyright © 2007 Wiley Periodicals, Inc.
Keywords: soluble CD40 ligand, HsC‐reactive protein, coronary disease, inflammation
Full Text
The Full Text of this article is available as a PDF (158.8 KB).
REFERENCES
- 1. Scarabin PY, Arveiler D, Amouyel P: Plasma fibrinogen explains much of the difference in risk of coronary heart disease between France and Northern Ireland: The PRIME study. Atherosclerosis 2003; 166: 103–109. [DOI] [PubMed] [Google Scholar]
- 2. Ridker PM, Rifai N, Rose L: Comparison of C‐reactive protein and low‐density lipoprotein cholesterol levels in the prediction of first cardiovascular events. N Engl J Med 2002; 347: 1557–1565. [DOI] [PubMed] [Google Scholar]
- 3. Lutgens E, Daemen MJ: CD40–CD40L interactions in atherosclerosis. Trends Cardiovasc Med 2002; 12: 27–32. [DOI] [PubMed] [Google Scholar]
- 4. Schon̈beck U, Libby P: CD40 signaling and plaque instability. Circ Res 2001; 89: 1092–1103. [DOI] [PubMed] [Google Scholar]
- 5. Aukrust P, Muller F, Ueland T: Enhanced levels of soluble and membrane‐bound CD40 ligand in patients with unstable angina. Possible reflection of T lymphocyte and platelet involvement in the pathogenesis of acute coronary syndromes. Circulation 1999; 100: 614–620. [DOI] [PubMed] [Google Scholar]
- 6. Cipollone F, Mezzetti A, Porreca E: Association between enhanced soluble CD40L and prothrombotic state in hypercholesterolemia: Effects of statin therapy. Circulation 2002; 106: 399–402. [DOI] [PubMed] [Google Scholar]
- 7. Schon̈beck U, Varo N, Libby P: Soluble CD40L and cardiovascular risk in women. Circulation 2001; 104: 2266–2268. [DOI] [PubMed] [Google Scholar]
- 8. Ejiri J, Inoue N, Kobayashi S: Possible role of brain‐derived neurotrophic factor in the pathogenesis of coronary artery disease. Circulation 2005; 112: 2114–2120. [DOI] [PubMed] [Google Scholar]
- 9. Ambrose JA, Winters SL, Arora RR: Coronary angiographic morphology in myocardial infarction: A link between the pathogenesis of unstable angina and myocardial infarction. J Am Coll Cardiol 1985; 6: 1233–1238. [DOI] [PubMed] [Google Scholar]
- 10. Chester MR, Chen L, Tousoulis D: Differential progression of complex and smooth stenoses within the same coronary tree in men with stable coronary artery disease. J Am Coll Cardiol 1995; 25: 837–842. [DOI] [PubMed] [Google Scholar]
- 11. Yasuda T, Shimizu M, Ino H: Coronary lesion morphology and prognosis in young males with myocardial infarction with or without familial hypercholesterolemia. Jpn Circ J 2001; 65: 247–250. [DOI] [PubMed] [Google Scholar]
- 12. Kinlay S, Schwartz GG, Olsson AG: Effect of atorvastatin on risk of recurrent cardiovascular events after an acute coronary syndrome associated with high soluble CD40 ligand in the Myocardial Ischemia Reduction with Aggressive Cholesterol Lowering (MIRACL) Study. Circulation 2004; 110: 386–391. [DOI] [PubMed] [Google Scholar]
- 13. Heeschen C, Dimmeler S, Hamm CW: Soluble CD40 ligand in acute coronary syndromes. N Engl J Med 2003; 348: 1104–1111. [DOI] [PubMed] [Google Scholar]
- 14. Varo N, de Lemos JA, Libby P: Soluble CD40L: Risk prediction after acute coronary syndromes. Circulation 2003; 108: 1049–1052. [DOI] [PubMed] [Google Scholar]
- 15. Ohashi Y, Kawashima S, Mori T: Soluble CD40 ligand and interleukin‐6 in the coronary circulation after acute myocardial infarction. Int J Cardiol 2006; 112: 52–58. [DOI] [PubMed] [Google Scholar]
- 16. Andre P, Nannizzi‐Alaimo L, Prasad SK: Platelet‐derived CD40L: The switch‐hitting player of cardiovascular disease. Circulation 2002; 106: 896–899. [DOI] [PubMed] [Google Scholar]
- 17. Inoue T, Kato T, Uchida T: Local release of C‐reactive protein from vulnerable plaque or coronary arterial wall injured by stenting. J Am Coll Cardiol 2005; 46: 239–245. [DOI] [PubMed] [Google Scholar]