Soluble CD40L Is a Useful Marker to Predict Future Strokes in Patients With Minor Stroke and Transient Ischemic Attack
Jie-Jie Lia b c d e f, Yi-Long Wanga b c d e f, Jin-Xi Lina b c d e f, David Z. Wanga b c d e f, An-Xin Wanga b c d e f, Xing-Quan Zhaoa b c d e f, Li-Ping Liua b c d e f, Chun-Xue Wanga b c d e f, Yong-Jun Wanga b c d e f
- aFrom the Department of Neurology, Beijing Tiantan Hospital, Capital Medical University, Beijing, China (J.L., Yilong Wang, J.L., A.W., X.Z., L.L., C.W., Yongjun Wang)
- bChina National Clinical Research Center for Neurological Diseases, Beijing, China (Yongjun Wang)
- cCenter of Stroke, Beijing Institute for Brain Disorders, Beijing, China (Yongjun Wang)
- dBeijing Key Laboratory of Translational Medicine for Cerebrovascular Disease, Beijing, China (Yongjun Wang); and Illinois Neurological, Institute
- eBeijing Key Laboratory of Translational Medicine for Cerebrovascular Disease, Beijing, China (Yongjun Wang)
- fIllinois Neurological, Institute Stroke Network, Sisters of the Third Order of St. Francis Healthcare System, University of Illinois College of Medicine, Peoria (D.W.)
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Abstract
BACKGROUND AND PURPOSE: Elevated soluble CD40 ligand (sCD40L) was shown to be related to cardiovascular events, but the role of sCD40L in predicting recurrent stroke remains unclear. METHODS: Baseline sCD40L levels were measured in 3044 consecutive patients with acute minor stroke and transient ischemic attack, who had previously been enrolled in the Clopidogrel in High-Risk Patients With Acute Nondisabling Cerebrovascular Events (CHANCE) trial. Cox proportional-hazards model was used to assess the association of sCD40L with recurrent stroke. RESULTS: Patients in the top tertile of sCD40L levels had increased risk of recurrent stroke comparing with those in the bottom tertile, after adjusted for conventional confounding factors (hazard ratio, 1.49; 95% confidence interval, 1.11-2.00; P=0.008). The patients with elevated levels of both sCD40L and high-sensitive C-reactive protein also had increased risk of recurrent stroke (hazard ratio, 1.81; 95% confidence interval, 1.23-2.68; P=0.003). CONCLUSIONS: Elevated sCD40L levels independently predict recurrent stroke in patients with minor stroke and transient ischemic attack. CLINICAL TRIAL REGISTRATION: URL: http://www.clinicaltrials.gov. Unique identifier: NCT00979589.
TL;DRElevated sCD40L levels independently predict recurrent stroke in patients with minor stroke and transient ischemic attack, after adjusted for conventional confounding factors. (Semantic Scholar)