© 2003 by BMJ Publishing Group & British Cardiac Society
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Ischaemic heart disease
CD40 ligand is released from activated lymphocytes and platelets, and is proinflammatory. The concentrations of soluble CD40 ligand were raised (above 5.0 µg/l) in 221 of 626 patients with acute coronary syndromes (40.6%). Raised soluble CD40 ligand values identified those with acute coronary syndromes who were at high risk for death or non-fatal myocardial infarction (MI) (hazard ratio v with those with low levels, 6.65, 95% confidence interval (CI) 3.18 to 13.89; p < 0.001) independent of troponin concentrations. Elevation of soluble CD40 ligand identifies a subgroup of patients at high risk who are likely to benefit from antiplatelet treatment with abciximab (adjusted hazard ratio as compared with those receiving placebo, 0.37, 95% CI 0.20 to 0.68; p = 0.001). Whether this adds to assessment using C reactive protein, a better validated risk marker, was not tested.
Heeschen C, Dimmeler S, Hamm CW, van den Brand MJ, Boersma E,
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