The Clinical Implications of High Expression of CD40L in Patients with Acute Coronary Syndromes

Objective: To investigate the clinical implications of the expression of CD40L on peripheral blood monocytes and the changes of serum soluble CD40L in patients with ACS. Methods: 16 normal controls and 56 patients, including 24 with SA (8 patients treated by PTCA), 20 with UA and 12 with AMI entered this study. The expression of CD40L in monocytes was analyzed by indirect-immunofluorescence flow cytometry, and the serum sCD40L levels were measured by ELISA. Results: (1) The expression of CD40L in monocytes were higher in UA and AMI than in SA and controls (P0.01), while no significant difference was found between SA and controls (P0.05). (2) The levels of serum sCD40L in patients with UA and AMI were higher than with SA and controls (P0.01). Values also differed significantly between patients with SA and controls (P0.05). (3) The levels of sCD40L in the patients with AMI, showed no significant increase when compared to patients with UA, had a peak at 24h after AMI. (4) PTCA induced a marked increase in sCD40L levels (P0.01), while the expression of CD40L on monocytes not. Conclusions: The enhanced level of serum soluble CD40L might be a reliable prognostic indicator for ACS and might be as a marker of the activity of the coronary lesion.