Soluble CD40L and cardiovascular risk in women

• Published in: Circulation (New York, N.Y.) Vol. 104; no. 19; pp. 2266 - 2268
• Main Authors: SCHÖNBECK, Uwe, VARO, Nerea, LIBBY, Peter, BURING, Julie, RIDKER, Paul M
• Format: Journal Article
• Language: English
• Published: Hagerstown, MD Lippincott Williams & Wilkins 06.11.2001; American Heart Association, Inc
• Subjects: Atherosclerosis (general aspects, experimental research); Biological and medical sciences; Blood and lymphatic vessels; Cardiology. Vascular system; Cardiovascular Diseases - blood; Cardiovascular Diseases - epidemiology; Case-Control Studies; CD40 Ligand - blood; Cholesterol, LDL - blood; Enzyme-Linked Immunosorbent Assay; Female; Follow-Up Studies; Humans; Medical sciences; Middle Aged; Odds Ratio; Predictive Value of Tests; Prospective Studies; Risk; Risk Factors; Smoking - epidemiology; Triglycerides - blood; United States - epidemiology; United States; Vascular disease; Human; Acute; CD40 ligand; Atherosclerosis; Risk factor; Biological marker; Cardiovascular disease; Exploration; Female
• ISSN: 0009-7322; 1524-4539
• DOI: 10.1161/hc4401.099447

The immune-signaling dyad CD40/CD40L promotes atherogenesis, and patients with unstable angina have elevated plasma levels of soluble CD40L (sCD40L) and membrane-bound CD40L. It is unknown, however, whether elevations of circulating sCD40L precede the onset of acute cardiovascular symptoms. In a prospective, nested case-control evaluation of healthy middle-aged women, mean concentrations of sCD40L at baseline were significantly higher among 130 participants who subsequently developed myocardial infarction, stroke, or cardiovascular death (cases), compared with 130 age- and smoking-matched women who remained free of cardiovascular disease (controls) during a 4-year follow-up (2.86 ng/mL for cases versus 2.09 ng/mL for controls; P=0.02). Women with concentrations above the 95th percentile of the control distribution (>3.71 ng/mL) had a significantly increased relative risk (RR) of developing future cardiovascular events (RR, 3.3; 95% CI, 1.2 to 8.6; P=0.01) that remained after adjustment for usual cardiovascular risk factors (multivariate RR, 2.8; 95% CI, 0.9 to 8.0; P=0.05). High plasma concentrations of sCD40L may be associated with increased vascular risk in apparently healthy women.