title: Association of CD40 ligand levels in the culprit coronary arteries with subsequent prognosis of acute myocardial infarction.
abstract: OBJECTIVE
  CD40 ligand (CD40L) plays a crucial role in atherogenesis and plaque destabilization. The purpose of this study was to clarify the association of CD40L levels in the culprit coronary arteries (CA) with the subsequent cardiovascular events in patients with acute myocardial infarction (AMI).
  
  
  METHODS
  We enrolled 68 patients with AMI whose CA were treated using thrombectomy devices. Blood samples were collected from the peripheral veins (PV), the ascending aortae (AO) and CA.
  
  
  RESULTS
  CD40L levels in the CA were significantly greater than those in the PV and AO. Statistical analyses revealed that CD40L levels in CA correlated positively with the corrected TIMI frame counts and maximal serum creatine kinase-MB in throughout clinical course, and inversely with myocardial blush grade and left ventricular ejection fraction 6 months after AMI. In logistic regression analyses, the group with high CD40L levels in CA was associated with an 8.58-fold increase in the odds of a cardiovascular event rate compared with the group with low CD40L levels.
  
  
  CONCLUSIONS
  In patients with AMI, enhanced CD40L levels in CA might affect myocardial perfusion, myocardial damage, and subsequent cardiovascular events, and could be a predictive marker for the prognosis of AMI.
authors.affiliation: Department of Medicine, Jichi Medical University Saitama Medical Center, 1-847 Amanuma Omiya-ku, Saitama, Saitama 330-8503, Japan.
authors.forename: Toru
authors.initials: T
authors.lastname: Yoshioka
authors.forename: Hiroshi
authors.initials: H
authors.lastname: Funayama
authors.forename: Hirotaka
authors.initials: H
authors.lastname: Hoshino
authors.forename: Tomohiro
authors.initials: T
authors.lastname: Nakamura
authors.forename: Yoshitaka
authors.initials: Y
authors.lastname: Sugawara
authors.forename: Norifumi
authors.initials: N
authors.lastname: Kubo
authors.forename: Osamu
authors.initials: O
authors.lastname: Nagata
authors.forename: Junya
authors.initials: J
authors.lastname: Ako
authors.forename: San-e
authors.initials: SE
authors.lastname: Ishikawa
authors.forename: Masanobu
authors.initials: M
authors.lastname: Kawakami
authors.forename: Shin-ichi
authors.initials: S
authors.lastname: Momomura
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001011:Aorta / Q000473:pathology; D023201:CD40 Ligand / Q000096:biosynthesis*; D017023:Coronary Angiography / Q000379:methods; D003326:Coronary Circulation; D003331:Coronary Vessels / Q000378:metabolism*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D009203:Myocardial Infarction / Q000097:blood*; D017131:Thrombectomy / Q000379:methods
chemical_list: D023201:CD40 Ligand