Journal
CIRCULATION
Volume 104, Issue 19, Pages 2266-2268Publisher
LIPPINCOTT WILLIAMS & WILKINS
DOI: 10.1161/hc4401.099447
Keywords
atherosclerosis; immune system; risk factors
Funding
- NHLBI NIH HHS [HL-58755, HL-63293, HL-56985, HL-34636] Funding Source: Medline
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Background-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. Methods and Results-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% Cl, 1.2 to 8.6; P=0.01) that remained after adjustment for usual cardiovascular risk factors (multivariate RR, 2.8; 95% Cl, 0.9 to 8.0; P=0.05). Conclusions-High plasma concentrations of sCD40L may be associated with increased vascular risk in apparently healthy women.
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