The Role of Serum sCD40L in Acute Coronary Syndrome

Background: Acute coronary syndrome (ACS) is caused by the sudden formation of blood clots within a coronary artery. The blood clots are caused by rupture of a plaque in the wall of the artery. Platelet aggregation is a complex reaction involving multiple mechanisms in platelet activation; it plays a significant role in the etiology of cardiovascular disease. Serum sCD40 ligand (sCD40L) is a biomarker of platelet activation. The aim of this study was to highlight the role of serum sCD40L in ACS patients as platelet activation marker for early detection and prevention of acute myocardial infraction (AMI). Patients and methods: The study involved 40 subjects with coronary affection (15 patients with unstable angina (UA) and 15 subjects with acute MI and 10 patients with depressed ST segment with MI) and 40 apparently healthy subjects as control group. Patients and control were subjected to carful history taking full clinical examination, ECG, echocardiography, lipid profile, creatine kinase (total and MB), troponin-I and serum sCD40L. Results: There was highly significant increase of serum sCD40L in all ACS patient groups when compared to control group. There was marked increase in serum sCD40L in patients with AMI compared with other patient groups. There was significant positive correlation between serum sCD40L and serum creatine kinase (CK) (total & MB), serum total cholesterol, serum triglyceride and serum LDL and significant negative correlation with serum HDL. Conclusion: Serum sCD40L can be used for early detection of platelet activation in ACS to avoid the risk of acute MI complications. We recommend its use as a marker of platelet activation in ACS.