Soluble CD40L and cardiovascular risk in women.
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.


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% 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).


CONCLUSIONS
High plasma concentrations of sCD40L may be associated with increased vascular risk in apparently healthy women.
Schönbeck
U
U
Leducq Center for Cardiovascular Research, Cardiovascular Medicine, Brigham and Women's Hospital, Boston, Massachusetts, USA. uschoenbeck@rics.bwh.harvard.edu
Varo
N
N
Libby
P
P
Buring
J
J
Ridker
P M
PM
D023201:CD40 Ligand / Q000097:blood*; D002318:Cardiovascular Diseases / Q000097:blood* / Q000453:epidemiology*; D016022:Case-Control Studies; D008078:Cholesterol, LDL / Q000097:blood; D004797:Enzyme-Linked Immunosorbent Assay; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008875:Middle Aged; D016017:Odds Ratio; D011237:Predictive Value of Tests; D011446:Prospective Studies; D012306:Risk; D012307:Risk Factors; D012907:Smoking / Q000453:epidemiology; D014280:Triglycerides / Q000097:blood; D014481:United States / Q000453:epidemiology
D008078:Cholesterol, LDL; D014280:Triglycerides; D023201:CD40 Ligand