OBJECTIVE: Atrial fibrillation (AF) is associated with a high incidence of vascular disease that may be related to a prothrombotic and inflammatory state. Soluble CD40 ligand (sCD40L), which stems essentially from platelet activation, possesses inflammatory and prothrombotic properties. The aim of the study was to assess whether sCD40L is a predictor of stroke or myocardial infarction (MI) in patients with nonvalvular AF. METHODS AND RESULTS: Plasma levels of sCD40L were measured in 231 patients (177 [77%] had permanent or persistent AF, and 54 [23%] had paroxysmal AF). Patients were followed for a mean period of 27.8+/-8.8 months, and cardiovascular events such as fatal and nonfatal stroke and MI were recorded. AF population was divided in 2 groups according to sCD40L level above or below the median (4.76 ng/mL). The 2 patients' groups had similar distribution of cardiovascular risk factors, age, gender, medications, or serum C-reactive protein levels. During the follow-up period, vascular events occurred in 6 (2 nonfatal MI and 4 nonfatal ischemic strokes) of 116 patients with low levels of sCD40L (5.1%) and in 29 (11 fatal and 3 nonfatal MI; 3 fatal and 12 nonfatal ischemic strokes) of 115 patients with high levels (25.2%) (log-rank test: P<0.001). Using the COX proportional Hazards model, patients with sCD40L above the median were 4.63 times more likely to experience a vascular event (95% C.I.: 1.92 to 11.20). CONCLUSIONS: This study shows that enhanced soluble CD40L level is a predictor of vascular events in patients with nonvalvular AF, thus suggesting that enhanced platelet activation may play a role in its clinical progression.
OBJECTIVE:Atrial fibrillation (AF) is associated with a high incidence of vascular disease that may be related to a prothrombotic and inflammatory state. Soluble CD40 ligand (sCD40L), which stems essentially from platelet activation, possesses inflammatory and prothrombotic properties. The aim of the study was to assess whether sCD40L is a predictor of stroke or myocardial infarction (MI) in patients with nonvalvular AF. METHODS AND RESULTS: Plasma levels of sCD40L were measured in 231 patients (177 [77%] had permanent or persistent AF, and 54 [23%] had paroxysmal AF). Patients were followed for a mean period of 27.8+/-8.8 months, and cardiovascular events such as fatal and nonfatal stroke and MI were recorded. AF population was divided in 2 groups according to sCD40L level above or below the median (4.76 ng/mL). The 2 patients' groups had similar distribution of cardiovascular risk factors, age, gender, medications, or serum C-reactive protein levels. During the follow-up period, vascular events occurred in 6 (2 nonfatal MI and 4 nonfatal ischemic strokes) of 116 patients with low levels of sCD40L (5.1%) and in 29 (11 fatal and 3 nonfatal MI; 3 fatal and 12 nonfatal ischemic strokes) of 115 patients with high levels (25.2%) (log-rank test: P<0.001). Using the COX proportional Hazards model, patients with sCD40L above the median were 4.63 times more likely to experience a vascular event (95% C.I.: 1.92 to 11.20). CONCLUSIONS: This study shows that enhanced soluble CD40L level is a predictor of vascular events in patients with nonvalvular AF, thus suggesting that enhanced platelet activation may play a role in its clinical progression.
Authors: Joachim R Ehrlich; Magdalena Kaluzny; Stefan Baumann; Ralf Lehmann; Stefan H Hohnloser Journal: Clin Res Cardiol Date: 2011-07-03 Impact factor: 5.460
Authors: Amgad Mentias; Ghanshyam Shantha; Oluwaseun Adeola; Geoffrey D Barnes; Bharat Narasimhan; Konstantinos C Siontis; Deborah A Levine; Rajan Sah; Michael C Giudici; Mary Vaughan Sarrazin Journal: Am Heart J Date: 2019-05-10 Impact factor: 4.749
Authors: Rainer Malik; Matthew Traylor; Sara L Pulit; Steve Bevan; Jemma C Hopewell; Elizabeth G Holliday; Wei Zhao; Patricia Abrantes; Philippe Amouyel; John R Attia; Thomas W K Battey; Klaus Berger; Giorgio B Boncoraglio; Ganesh Chauhan; Yu-Ching Cheng; Wei-Min Chen; Robert Clarke; Ioana Cotlarciuc; Stephanie Debette; Guido J Falcone; Jose M Ferro; Dale M Gamble; Andreea Ilinca; Steven J Kittner; Christina E Kourkoulis; Robin Lemmens; Christopher R Levi; Peter Lichtner; Arne Lindgren; Jingmin Liu; James F Meschia; Braxton D Mitchell; Sofia A Oliveira; Joana Pera; Alex P Reiner; Peter M Rothwell; Pankaj Sharma; Agnieszka Slowik; Cathie L M Sudlow; Turgut Tatlisumak; Vincent Thijs; Astrid M Vicente; Daniel Woo; Sudha Seshadri; Danish Saleheen; Jonathan Rosand; Hugh S Markus; Bradford B Worrall; Martin Dichgans Journal: Neurology Date: 2016-03-02 Impact factor: 9.910