The Clinical Value Of Serum SCD40L Level Elevated In Acute Coronary Syndrome

Objective: Acute coronary syndrome (ACS) which take place following the rupture or erosion of coronary atherosclerosis and thrombosis is a clinical syndrome that includes unstable angina, acute myocardial infarction and sudden death. Many studys suggested that inflammation plays a crucial role in initiation, evolution and rupture of atherosclerotic plaque. It is an important clinical issue to identify vulnerable plaque, predict the danger of ACS and prevent the happening of ACS. The role of signal pathway of CD40-CD40L in inflammation which connected with atherosclerosis is becoming clear more and more. It takes effect in the occurring, developing of atherosclerosis and rupture of plaque. sCD40L is soluble segment of CD40L molecular, which has biologic function of CD40L. The purpose of this study is to investigate the relationship between sCD40L and IL-6, IL-1β in ACS. And to investigate the value of sCD40L in ACS.Methods: Sixty patients with coronary heart disease (CHD) were enrolled. They were divided into three groups: 20 patients with acute myocardial infarction (group A), 20 patients with unstable angina pectoris (group B) and 20 patients with angina pectoris (group C) .The control group included 20 patients (group D). Blood samples (6 ml) were drown immediatedly after admission and were stored at -80℃ until assayed. Creatine phosphokinase, electrolyte, electrocardiogram, renal function cholesterol and triglyceride were examined in all patients. Serum level of sCD40L was measured by ELISA. The serum levels of IL-6 and IL-1β were measured by a specific radioimmunoassay. Cholesterol and triglyceride concentrations were detected with commercially available enzymatic methods. The polyethylene glycol precipitation method was used to determine high-density lipoprotein cholesterol. Low-density lipoprotein cholesterol was calculated by the Friedewald formula: LDL-c=Tc-HDL-c-TG/2.2(mmol/L). Results: sCD40L level in patients with acute myocardial infarction (4.923±3.41 ng/ml)and unstable angina (5.387±3.04 ng/ml)was significantly higher than that in patients with stable angina(2.856±2.34ng/ml, p<0.05),and control group(2.221±2.42 , p<0.01). sCD40L level was positively correlated with IL -6(r=0.49,P=0.008)and not correlated with IL- 1?(r=0.258,P=0.183). The level of sCD40L in patients with stable angina and control was not correlated with both IL -6 and IL -1? . sCD40L level was significantly positive correlated to LDL(r=0.471,P=0.011)and negative correlated with HDL(R=-0.433,P=0.021), but was not correlated to age, hypertension and weight. Conclusion: The result suggested: ⑴The serum level of sCD40L in AMI and UAP patients was significantly greater than that in SAP and control group; ⑵The level of sCD40L was significantly positively correlated with IL-6, LDL-C and was negatively correlated with HDL-C; ⑶sCD40L, IL-6 and IL-1β may be the sign of vulnerable plaque of AS.