The Relationship Of SCD40L To Unstable Angina Pectoris And The Short-term Prognosis

Objectives: 1. Through contrasting the variance of sCD40L among unstable angina pectoris group, stable angina pectoris group and the control group, to explore the role of sCD40L in the pathogenesis of unstable angina pectoris.2. By studying the relevance of sCD40L to recent acute cardiovascular events (including sudden cardiac death, nonfatal myocardial infarction and emegency percutaneous coronary intervention that was necessary to illness)and risk stratification, to explore the effects of sCD40L on the short-term prognosis of patients with unstable angina pectoris.Methods: Sixty-nine patients with coronary heart disease (49 patients with unstable angina pectoris, 20 patients with stable angina pectoris respectively) were enrolled in this study , who were verified by coronarography that the stenosis was≥50% of the vessel diameter at least in one of the coronary arteries. 69 patients were selected according to the diagnosis and treatment guideline (2007) for unstable angina pectoris / non-ST segment elevation myocardial infarction and that for stable angina pectoris formulated by Chinese Society of Cardiology / EditorialBoard of Chinese Journal of Cardiology respectively. Meanwhile, 20 contemporaneous cases of no coronary heart disease verified by coronarography were chosed as the controls.The 20 cases were hospitalized for atypical chest pain or for physical health examination. The plasma levels of sCD40L in three groups were detected in the method of enzyme-linked immunosorbent assays. All patients with UAP were evaluated with GRACE risk score on admission and had been followed up for 30 days from hospitalization. Clinical endpoints were sudden cardiac death, nonfatal myocardial infarction or emegency percutaneous coronary intervention that was necessary to illness at 30-days follow-up.Results: 1. The plasma level of sCD40L in UAP group [(9.39±1.89)ng/ml] was significantly higher than that in SAP group [(5.92±2.06)ng/ml] and in the control group [(4.91±1.97)ng/ml] (P<0.01). The plasma level of sCD40L in SAP group was higher than that in the control group, but the difference had no statistical significance.2. 49 patients with unstable angina pectoris were devided into elevated sCD40L group and normal sCD40L group according to the plasma levels of sCD40L .The incidence of acute cardiovascular events in elevated sCD40L group (51.7%) was significantly higher than that in normal sCD40L group(10%), the difference had statistical significance (P<0.05).3. The plasma level of sCD40L in high-risk group was significantly higher than that in moderate-risk group and in low-risk group(P<0.01), in moderate-risk group was also significantly higher than in low-risk group . The plasma levels of sCD40L in three groups of risk stratification were (11.93±1.06)ng/ml, (9.15±0.96)ng/ml and (7.35±0.89)ng/ml respectively.Conclusions: 1. Served as proinflammatory and prothrombotic factor , sCD40L may have regulating effect on the pathogenesis of unstable angina pectoris.2. sCD40L have influence on the recent prognosis of unstable angina pectoris. The plasma level of sCD40L was correlated with risk stratification in patients with unstable angina pectoris. sCD40L can be served as valuable marker in risk stratification for unstable angina pectoris clinically.