title: Predictive value of elevated soluble CD40 ligand in patients undergoing primary angioplasty for ST-segment elevation myocardial infarction.
abstract: OBJECTIVE
  The aim of this study was to evaluate the prognostic value of soluble CD40 ligand (sCD40L) in patients with ST-segment elevation myocardial infarction (STEMI) undergoing a primary percutaneous coronary intervention (PCI).
  
  
  BACKGROUND
  The prognostic value of sCD40L has been documented in patients with acute coronary syndrome; however, its value in acute STEMI remains unclear.
  
  
  METHODS
  We prospectively enrolled 499 consecutive STEMI patients (397 men, 102 women) undergoing primary PCI. The study population was divided into tertiles on the basis of admission sCD40L values. The high sCD40L group (n=168) included patients with a value in the third tertile (≥0.947 mg/l) and the low sCD40L group (n=331) included patients with a value in the lower two tertiles (<0.947 mg/l). Clinical characteristics and in-hospital and 1-year primary PCI outcomes were analyzed.
  
  
  RESULTS
  The patients in the high sCD40L group were older (mean age 57.3±12.7 vs. 54.8±11.9, P=0.029). Higher in-hospital and 1-year all-cause mortality rates were observed in the high sCD40L group (7.7 vs. 3.3%, P=0.029; 16.1 vs. 4.8%, P<0.001, respectively). The results of Cox multivariate analysis indicated that a high sCD40L value at admission (>0.947 mg/l) is a powerful independent predictor of 1-year all-cause mortality (odds ratio: 3.68; 95% confidence interval: 1.54-8.77; P=0.003).
  
  
  CONCLUSIONS
  The results of this study suggest that a high sCD40L level at admission is associated with increased in-hospital and 1-year all-cause mortality rates in patients with STEMI undergoing primary PCI.
authors.affiliation: aDepartment of Cardiology, Mehmet Akif Ersoy Thoracic and Cardiovascular Surgery Center, Training and Research Hospital bDepartment of Cardiology, School of Medicine, Bezmialem Vakıf University cDepartment of Cardiology, Acıbadem University, Istanbul dDepartment of Cardiology, Erzurum State Training and Research Hospital, Erzurum eDepartment of Cardiology, Rize Education and Research Hospital, Rize, Turkey.
authors.forename: Hamdi
authors.initials: H
authors.lastname: Pusuroglu
authors.forename: Ozgur
authors.initials: O
authors.lastname: Akgul
authors.forename: Mehmet
authors.initials: M
authors.lastname: Erturk
authors.forename: Huseyin
authors.initials: H
authors.lastname: Uyarel
authors.forename: Umit
authors.initials: U
authors.lastname: Bulut
authors.forename: Emre
authors.initials: E
authors.lastname: Akkaya
authors.forename: Ali
authors.initials: A
authors.lastname: Buturak
authors.forename: Ozgur
authors.initials: O
authors.lastname: Surgit
authors.forename: Ali
authors.initials: A
authors.lastname: Fuat
authors.forename: Mustafa
authors.initials: M
authors.lastname: Cetin
authors.forename: Aydn
authors.initials: A
authors.lastname: Yldrm
mesh_terms: D054058:Acute Coronary Syndrome / Q000097:blood* / Q000401:mortality / Q000628:therapy; D000328:Adult; D000368:Aged; D015906:Angioplasty, Balloon, Coronary; D023201:CD40 Ligand / Q000097:blood*; D005260:Female; D017052:Hospital Mortality; D006801:Humans; D008297:Male; D008875:Middle Aged; D015999:Multivariate Analysis; D009203:Myocardial Infarction / Q000097:blood* / Q000401:mortality / Q000628:therapy; D011379:Prognosis; D016016:Proportional Hazards Models; D016896:Treatment Outcome
chemical_list: D023201:CD40 Ligand