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Coronary Progenitor Cells and Soluble Biomarkers in Cardiovascular Prognosis after Coronary Angioplasty
Published on: January 28, 2020
Predictive value of elevated soluble CD40 ligand in patients undergoing primary angioplasty for ST-segment elevation
Hamdi Pusuroglu1, Ozgur Akgul, Mehmet Erturk
1aDepartment of Cardiology, Mehmet Akif Ersoy Thoracic and Cardiovascular Surgery Center, Training and Research Hospital bDepartment of Cardiology, School of Medicine, Bezmialem Vakıf University cDepartment of Cardiology, Acıbadem University, Istanbul dDepartment of Cardiology, Erzurum State Training and Research Hospital, Erzurum eDepartment of Cardiology, Rize Education and Research Hospital, Rize, Turkey.
Insights
High soluble CD40 ligand (sCD40L) levels in ST-segment elevation myocardial infarction (STEMI) patients undergoing primary percutaneous coronary intervention (PCI) predict increased mortality. This finding highlights sCD40L as a potential prognostic biomarker for STEMI patients.
Area of Science:
- Cardiology
- Biomarkers
- Myocardial Infarction Research
Background:
- The prognostic significance of soluble CD40 ligand (sCD40L) is established in acute coronary syndromes, but its specific role in ST-segment elevation myocardial infarction (STEMI) requires further clarification.
- Understanding biomarkers for risk stratification in STEMI is crucial for improving patient outcomes.
Purpose of the Study:
- To investigate the prognostic value of soluble CD40 ligand (sCD40L) in patients diagnosed with ST-segment elevation myocardial infarction (STEMI).
- To assess the association between sCD40L levels and outcomes in STEMI patients who have undergone primary percutaneous coronary intervention (PCI).
Main Methods:
- Prospective enrollment of 499 STEMI patients undergoing primary PCI.
- Stratification of patients into tertiles based on admission sCD40L levels: high (≥0.947 mg/l) and low (<0.947 mg/l).
- Analysis of clinical characteristics and in-hospital and 1-year mortality rates post-PCI.
Main Results:
- Patients in the high sCD40L group were older and exhibited significantly higher in-hospital (7.7% vs. 3.3%) and 1-year (16.1% vs. 4.8%) all-cause mortality rates.
- Cox multivariate analysis identified high sCD40L levels (>0.947 mg/l) as an independent predictor of 1-year all-cause mortality (OR: 3.68; 95% CI: 1.54-8.77).
Conclusions:
- Elevated sCD40L levels at admission are significantly associated with increased in-hospital and 1-year mortality in STEMI patients treated with primary PCI.
- sCD40L emerges as a potent independent prognostic biomarker for adverse outcomes in this patient cohort.
Objectives:
The aim of this study was to evaluate the prognostic value of soluble CD40 ligand (sCD40L) in patients with ST-segment elevation myocardial infarction (STEMI) undergoing a primary percutaneous coronary intervention (PCI).
Background:
The prognostic value of sCD40L has been documented in patients with acute coronary syndrome; however, its value in acute STEMI remains unclear.
Materials And Methods:
We prospectively enrolled 499 consecutive STEMI patients (397 men, 102 women) undergoing primary PCI. The study population was divided into tertiles on the basis of admission sCD40L values. The high sCD40L group (n=168) included patients with a value in the third tertile (≥0.947 mg/l) and the low sCD40L group (n=331) included patients with a value in the lower two tertiles (<0.947 mg/l). Clinical characteristics and in-hospital and 1-year primary PCI outcomes were analyzed.
Results:
The patients in the high sCD40L group were older (mean age 57.3±12.7 vs. 54.8±11.9, P=0.029). Higher in-hospital and 1-year all-cause mortality rates were observed in the high sCD40L group (7.7 vs. 3.3%, P=0.029; 16.1 vs. 4.8%, P<0.001, respectively). The results of Cox multivariate analysis indicated that a high sCD40L value at admission (>0.947 mg/l) is a powerful independent predictor of 1-year all-cause mortality (odds ratio: 3.68; 95% confidence interval: 1.54-8.77; P=0.003).
Conclusion:
The results of this study suggest that a high sCD40L level at admission is associated with increased in-hospital and 1-year all-cause mortality rates in patients with STEMI undergoing primary PCI.
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