title: [Relationship between serum level of CD40 ligand and persistent lone atrial fibrillation].
abstract: OBJECTIVE
  Inflammation is thought to play a role in the pathogenesis of atrial fibrillation. The relationship between CD40 ligand (CD40L), a prothrombotic and proinflammatory molecule, and lone atrial fibrillation was presently investigated for the first time. Levels of serum CD40L were also tested, regarding potential to distinguish patients with lone atrial fibrillation from healthy individuals.
  
  
  METHODS
  Presently included were 35 patients with lone persistent atrial fibrillation and a control group of 30 healthy individuals. Serum levels of CD40L and high-sensitive C-reactive protein (hs-CRP) were measured, and transthoracic echocardiography was performed.
  
  
  RESULTS
  Mean serum CD40L, hs-CRP, left ventricular end-diastolic diameter, and left atrial diameter values were significantly higher in the group with lone persistent atrial fibrillation than in the control group (7.4±3.5 ng/mL vs 4.3±1.2 ng/mL, p<0.0001; 3.7±1.6 mg/L vs 1.7±0.8 mg/L, p<0.0001; 53.0±4.2 mm vs 46.0±3.8, p<0.0001; 43.5±3.5 mm vs 33.7±3.5, p<0.0001, respectively). Serum CD40L levels were positively correlated with left atrial diameter (r=0.81, p<0.0001) and hs-CRP (r=0.72, p<0.0001). Receiver operating characteristic curve analysis revealed that serum CD40L at the optimal cut-off level of >4.5 ng/mL successfully discriminated patients with lone atrial fibrillation from controls (area under the curve: 0.847; 95% confidence interval: 0.759-0.934; p<0.0001).
  
  
  CONCLUSIONS
  The present findings suggest that CD40L levels play a crucial role in the development of lone atrial fibrillation. In addition, results support that regular clinical follow-up of these patients is necessary, due to increased cardiovascular disease risk, determined by elevated CD40L levels.
authors.affiliation: Department of Cardiology, Koç University Faculty of Medicine, İstanbul, Turkey. epolat@kuh.ku.edu.tr.
authors.forename: Evin
authors.initials: E
authors.lastname: Bozçalı
authors.affiliation: Department of Cardiology, Bakırköy Dr. Sadi Konuk Training and Research Hospital, İstanbul, Turkey.
authors.forename: Veli
authors.initials: V
authors.lastname: Polat
authors.affiliation: Department of Cardiology, İstinye State Hospital, İstanbul, Turkey.
authors.forename: Gönül
authors.initials: G
authors.lastname: Kutlu
authors.affiliation: Department of Cardiology, Bakırköy Dr. Sadi Konuk Training and Research Hospital, İstanbul, Turkey.
authors.forename: Selçuk
authors.initials: S
authors.lastname: Opan
authors.affiliation: Düzen Laboratory, İstanbul, Turkey.
authors.forename: Nurcan
authors.initials: N
authors.lastname: Paker
authors.affiliation: Department of Cardiology, Bakırköy Dr. Sadi Konuk Training and Research Hospital, İstanbul, Turkey.
authors.forename: Turgut
authors.initials: T
authors.lastname: Uygun
authors.affiliation: Department of Cardiology, İstanbul University Cardiology Institute, İstanbul, Turkey.
authors.forename: Barış
authors.initials: B
authors.lastname: Ökçün
authors.affiliation: Department of Cardiology, Bakırköy Dr. Sadi Konuk Training and Research Hospital, İstanbul, Turkey.
authors.forename: Osman
authors.initials: O
authors.lastname: Karakaya
mesh_terms: D000328:Adult; D001281:Atrial Fibrillation / Q000097:blood* / Q000453:epidemiology*; D015415:Biomarkers / Q000097:blood; D023201:CD40 Ligand / Q000097:blood*; D003430:Cross-Sectional Studies; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged
chemical_list: D015415:Biomarkers; D023201:CD40 Ligand