Prognostic value of plasma soluble CD40 ligand in patients with chronic non-valvular atrial fibrillation

Duygu, Hamza; Barışık, Vatan; Kurt, Hüseyin; Türk, Uğur Önsel; Ercan, Ertuğrul; Köse, Şükran

doi:10.1093/europace/eum284

Cited by 29 publications

(22 citation statements)

References 47 publications

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“…In this study, the vWF/ADAMTS 13 ratio was negatively correlated with LAA flow velocity (r=−0.345, P=0.002) [27]. Plasma-soluble CD40 ligand, a marker of platelet activation, was correlated with extent of SEC (r=0.377, P=0.02); however, levels of soluble CD40 ligand were not associated with warfarin use [28]. Soluble P-selectin and fibrin D-dimer levels, indicative of prolonged platelet activation and coagulability respectively, were increased in 17 patients with AF relative to 34 sinus rhythm controls [29].…”

Section: Risk Of Thromboembolic Stroke In Afmentioning

confidence: 50%

Stroke Prevention in Atrial Fibrillation: Atrial Appendage Closure

Fuller

Reisman

2011

Curr Cardiol Rep

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The left atrial appendage (LAA) is the primary nonvalvular cause of cardioembolic stroke in patients with atrial fibrillation (AF). Warfarin and direct thrombin inhibitors such as dabigatran are presumed to prevent formation of LAA thrombus, and are first-line treatments to prevent ischemic stroke in AF. However, these medications carry many contraindications such as hemorrhage, and can interact with many drugs and supplements. Epicardial and endovascular techniques for occlusion of LAA are being explored, whether to mitigate the need for anticoagulation in patients at risk of bleeding or as a first-line therapy to reduce the risk of thromboembolic stroke. The purposes of this article are to 1) review the LAA structure and its potential contribution to ischemic stroke; 2) discuss the results of surgical and endovascular trials of LAA occlusion on risk of stroke and adverse events in AF patients; and 3) present early data on devices in development.

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Section: Risk Of Thromboembolic Stroke In Afmentioning

confidence: 50%

Stroke Prevention in Atrial Fibrillation: Atrial Appendage Closure

Fuller

Reisman

2011

Curr Cardiol Rep

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“…21 Inflammatory mediation has been proposed; acuteonset AF triggers platelet activation and monocyte interaction within minutes 22 and platelets continue to express CD40 some weeks after successful cardioversion. 23 Although the cause-effect relationship is debated, this might explain the high rates of AF and TE, although it is not clear whether inflammation, or some other pathology, 24 persists to maintain TE risk over the duration we have observed.…”

Section: Discussionmentioning

confidence: 90%

Risk of thromboembolism in patients developing critical illness-associated atrial fibrillation

et al. 2018

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Although common, the long-term significance of -developing atrial fibrillation (AF) during a period of critical illness is unclear. We undertook a retrospective cohort analysis to -assess the rate of thromboembolism (TE) in patients -developing atrial fibrillation during admission to our intensive care unit. In total, 1,955 patients were followed up (-maximum follow-up 1,276 days) for the occurrence of TE, of which 220 (11.3%) had developed AF or atrial flutter during their critical care admission. There were 11 TE events among the patients with new AF (0.053 events per patient-year), compared with 18 in the non-AF group (0.0059 events per patient-year). The unadjusted hazard ratio for TE in patients developing new AF compared with those not developing AF was 8.09 (95% CI 3.08-17.19, p<0.001). In patients admitted to critical care, the development of AF appears to be associated with a significantly increased risk of subsequent thromboembolism.

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“…Besides, raised sCD40L levels were found in acute cerebral ischemia [11], peripheral artery disease [12], acute and chronic heart failure [13,14], and pulmonary arterial hypertension [17]. Interestingly, plasma sCD40L may prospectively predict stroke in AF and provide a useful marker to identify patients at high thromboembolic risk with nonvalvular AF [15].…”

Section: Discussionmentioning

confidence: 99%

“…High plasma concentrations of sCD40L were proposed to be associated with increased vascular risk [7][8][9]. There are several studies investigating the role of CD40L in various circumstances such as acute coronary syndromes [10], ischemic cerebrovascular accidents [11], peripheral artery diseases [12], heart failure [13,14], and atrial fibrillation (AF) [15]. Pulmonary arterial hypertension (PAH) is a complex disorder and both thrombus activation and inflammation seem to play an important role in pathogenesis [16].…”

Section: Introductionmentioning

confidence: 99%

Soluble CD40 ligand levels in acute pulmonary embolism: a prospective, randomized, controlled study

et al. 2011

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CD40 ligand is a thromboinflammatory molecule that predicts cardiovascular events. Platelets constitute the major source of soluble CD40 ligands (sCD40L), which has been shown to influence platelet activation. The main aim of this study was to evaluate sCD40L levels in patients with acute pulmonary embolism (PE). Sixty-five PE patients (32 males, mean age 58 ± 12 years) and 29 healthy controls (15 males, mean age 56 ± 14 years) were enrolled in the study. sCD40L levels were evaluated at the enrollment by ELISA method. Multislice detected pulmonary computed tomography was performed on all patients with a suspected diagnosis of PE. In addition, echocardiography was performed to evaluate right ventricular (RV) dysfunction. There was no statistically significant difference between the two groups regarding demographic features. sCD40L levels were significantly higher in acute PE group compared to healthy controls (5.3 ng/ml and 1.4 ng/ml, respectively; p < 0.001). sCD40L levels of patients with and without RV dysfunction were similar. Correlation analysis between echocardiographic findings and sCD40L levels did not show significant difference. The present study demonstrated a role of sCD40L in pathogenesis of PE for the first time. Further studies are needed to clarify a predictive and prognostic value of sCD40L levels in acute PE patients.

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Prognostic value of plasma soluble CD40 ligand in patients with chronic non-valvular atrial fibrillation

Abstract: Plasma sCD40L may prospectively predict stroke in AF. sCD40L may provide useful marker to identify patients at high thrombo-embolic risk with NVAF.

Cited by 29 publications

References 47 publications

Stroke Prevention in Atrial Fibrillation: Atrial Appendage Closure

Stroke Prevention in Atrial Fibrillation: Atrial Appendage Closure

Risk of thromboembolism in patients developing critical illness-associated atrial fibrillation

Soluble CD40 ligand levels in acute pulmonary embolism: a prospective, randomized, controlled study

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