title: Stratification of ST-elevation myocardial infarction patients based on soluble CD40L longitudinal changes.
abstract: Involvement of soluble CD40 ligand (sCD40L) in thrombosis and inflammation on the context of coronary artery disease is currently being revised. In that perspective, we had studied the association of sCD40L with markers of platelet activation and markers of endothelial and vascular function. On that cohort, a stratification of patients with acute myocardial infarction (AMI) 1 month after percutaneous coronary intervention (PCI) was observed based on concentrations of sCD40L. The study intended to identify the groups of AMI patients with different profiles of sCD40L concentrations and verify how medication, clinical evolution, biochemical data, and markers of regulation of endothelial function at genetic (endothelial nitric oxide synthase polymorphisms) and post-transcriptional levels (circulating microRNAs) affect sCD40L serum levels. Lower quartiles of sCD40L (<2.3 ng/mL) were associated with higher concentrations of N-terminal pro-brain natriuretic peptide (NT-proBNP), high frequency of G894T polymorphism, and altered expression of a set of microRNAs assumed to be involved in the regulation of endothelial and cardiac function and myocardium hypertrophy, relative to patients in sCD40L upper quartiles. A characteristic sCD40L variation pattern in STEMI patients was identified. Low levels of sCD40L 1 month after PCI distinguish STEMI patients with worse prognosis, a compromised cardiac healing, and a persistent endothelial dysfunction, as given by the association between sCD40L, NT-proBNP, G894T polymorphism, and specific profile of miRNA expression. These results suggest sCD40L could have a prognostic value in STEMI patients.
authors.affiliation: Carlota Saldanha Lab, Instituto Medicina Molecular (IMM), Faculdade de Medicina da Universidade de Lisboa, Lisboa, Portugal. Electronic address: pnapoleao@medicina.ulisboa.pt.
authors.forename: Patrícia
authors.initials: P
authors.lastname: Napoleão
authors.affiliation: IINFACTS-CESPU, Instituto de Investigação e Formação Avançada em Ciências e Tecnologias da Saúde, Penafiel, Portugal.
authors.forename: Luís B P
authors.initials: LB
authors.lastname: Cabral
authors.affiliation: Serviço Cardiologia, Hospital Santa Marta, Centro Hospitalar Lisboa Central (CHLC), Lisboa, Portugal.
authors.forename: Mafalda
authors.initials: M
authors.lastname: Selas
authors.affiliation: Serviço Cardiologia, Hospital Santa Marta, Centro Hospitalar Lisboa Central (CHLC), Lisboa, Portugal.
authors.forename: Cláudia
authors.initials: C
authors.lastname: Freixo
authors.affiliation: IINFACTS-CESPU, Instituto de Investigação e Formação Avançada em Ciências e Tecnologias da Saúde, Penafiel, Portugal.
authors.forename: Maria do Céu
authors.initials: Mdo C
authors.lastname: Monteiro
authors.affiliation: IINFACTS-CESPU, Instituto de Investigação e Formação Avançada em Ciências e Tecnologias da Saúde, Penafiel, Portugal.
authors.forename: Maria Begoña
authors.initials: MB
authors.lastname: Criado
authors.affiliation: Maria Carmo-Fonseca Lab, Instituto Medicina Molecular (IMM), Faculdade de Medicina da Universidade de Lisboa, Lisboa, Portugal.
authors.forename: Marina C
authors.initials: MC
authors.lastname: Costa
authors.affiliation: Maria Carmo-Fonseca Lab, Instituto Medicina Molecular (IMM), Faculdade de Medicina da Universidade de Lisboa, Lisboa, Portugal.
authors.forename: Francisco J
authors.initials: FJ
authors.lastname: Enguita
authors.affiliation: Centro de Estudos do Ambiente e do Mar (CESAM) & Departamento de Biologia Animal (DBA), Faculdade de Ciências da Universidade de Lisboa, Lisboa, Portugal.
authors.forename: Ana Maria
authors.initials: AM
authors.lastname: Viegas-Crespo
authors.affiliation: Carlota Saldanha Lab, Instituto Medicina Molecular (IMM), Faculdade de Medicina da Universidade de Lisboa, Lisboa, Portugal.
authors.forename: Carlota
authors.initials: C
authors.lastname: Saldanha
authors.affiliation: Serviço Cardiologia, Hospital Santa Marta, Centro Hospitalar Lisboa Central (CHLC), Lisboa, Portugal; Centro de Estudos de Doenças Crónicas (CEDOC), NOVA Medical School, Lisboa, Portugal.
authors.forename: Miguel Mota
authors.initials: MM
authors.lastname: Carmo
authors.affiliation: Serviço Cardiologia, Hospital Santa Marta, Centro Hospitalar Lisboa Central (CHLC), Lisboa, Portugal.
authors.forename: Rui Cruz
authors.initials: RC
authors.lastname: Ferreira
authors.affiliation: Instituto de Bioengenharia e Biociências (IBB), Departamento de Engenharia e Ciências Nucleares, Instituto Superior Técnico, Universidade de Lisboa, Lisboa, Portugal.
authors.forename: Teresa
authors.initials: T
authors.lastname: Pinheiro
mesh_terms: D000368:Aged; D023201:CD40 Ligand / Q000097:blood*; D016022:Case-Control Studies; D004562:Electrocardiography; D005260:Female; D020869:Gene Expression Profiling; D005838:Genotype; D006801:Humans; D008137:Longitudinal Studies; D008297:Male; D035683:MicroRNAs / Q000235:genetics / Q000378:metabolism; D008875:Middle Aged; D009203:Myocardial Infarction / Q000097:blood* / Q000000981:diagnostic imaging* / Q000235:genetics; D020097:Natriuretic Peptide, Brain / Q000097:blood; D052250:Nitric Oxide Synthase Type III / Q000235:genetics; D010446:Peptide Fragments / Q000097:blood; D062645:Percutaneous Coronary Intervention; D012995:Solubility
chemical_list: D035683:MicroRNAs; D010446:Peptide Fragments; C109794:pro-brain natriuretic peptide (1-76); D020097:Natriuretic Peptide, Brain; D023201:CD40 Ligand; C496314:NOS3 protein, human; D052250:Nitric Oxide Synthase Type III