Introduction: Soluble CD40 ligand (sCD40L) is directly involved in the development of vascular damage. We tested the hypothesis that sCD40L may be predictive cardiovascular (CV) events in patients at elevated risk such as patients on haemodialysis (HD). RiscAVID (Rischio cAardiovascolare nei pazienti afferenti nell'Area Vasta) study is an observational and prospective study of the over 800 patients on HD of the north-west part of Tuscany. Methods: In 300 patients (mean age: 66 years), recruited in 5 centres and representative of the whole RiscAVID population, plasma sCD40L levels were measured by immunoenzymathic methods (R&D systems, Minneapolis, MN, USA) at the time of the enrolment. Demographic, clinical and laboratory data as well as co-morbidity conditions were also registered. The population was followed up for 24 months and overall mortality, CV mortality and CV major non fatal events (acute myocardial infarction, stroke and ictus) were registered. Cox proportional hazards regression assessed adjusted differences in CV morbidity and mortality risk. Moreover, migration of endothelial cells and monocyte superoxide anion production were tested in vitro after incubation with patients' serum. Results: Patients were stratified according to plasma sCD40L levels in those with levels below (sCD40L-) and upon (sCD40L+) the median value of 7.6 ng/mL. At baseline, no significant difference were observed in age, gender, blood pressure values, previous CV events between the two groups. No significant difference was also observed in received single-pool extracorporeal substitutive treatment (Kt/V urea 1.43±0.17 and 1.48±0.22, respectively) or duration of HD (77±83 and 68±71 months, respectively). Moreover, elevated levels of sCD40L in HD patients were associated with a reduced migration of endothelial cells and increased monocyte superoxide anion production. Conclusions: These observational results at two-year follow-up in a population of patients on HD suggest that sCD40L, a marker of vascular inflammation and damage, could represent an important CV prognostic factor in HD patients.
scite is a Brooklyn-based organization that helps researchers better discover and understand research articles through Smart Citations–citations that display the context of the citation and describe whether the article provides supporting or contrasting evidence. scite is used by students and researchers from around the world and is funded in part by the National Science Foundation and the National Institute on Drug Abuse of the National Institutes of Health.