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Degrees of sCD40L pathway activation in coronary and multiterritorial atherosclerosis
Session:
Painel 12- Prevenção / Reabilitação Cardíaca 2
Speaker:
Tiago Luís Pinto Pereira da Silva
Congress:
CPC 2020
Topic:
G. Aortic Disease, Peripheral Vascular Disease, Stroke
Theme:
23. Peripheral Vascular and Cerebrovascular Disease
Subtheme:
23.1 Peripheral Vascular and Cerebrovascular Disease – Pathophysiology and Mechanisms
Session Type:
Posters
FP Number:
---
Authors:
Tiago Pereira Da Silva; Patrícia Napoleão; Teresa Pinheiro ; Mafalda Selas; Felipa Silva; António Valentim Gonçalves; Vera Ferreira; Rui Cruz Ferreira; Miguel Mota Carmo
Abstract
<p><strong>Introduction:</strong> The mechanisms underlying atherogenesis in different arterial beds and multiterritorial disease are poorly understood. Inflammation plays a central role in atherothrombosis, and soluble CD40 ligand (sCD40L) activates different cell types involved in innate immunity, including macrophages and platelets. We hypothesized that sCD40L pathway activation could be associated with different phenotypes of atherosclerosis. We aimed to evaluate if sCD40L expression is associated with the presence of stable coronary artery disease (SCAD) and with multiterritorial disease.</p> <p><strong>Methods:</strong> We prospectively recruited five groups of age- and sex-matched participants, with: 1) no coronary, carotid or inferior limbs atherosclerosis (controls); 2) isolated coronary artery disease (CAD); 3) coronary and inferior limbs atherosclerosis; 4) coronary and carotid atherosclerosis; 5) atherosclerosis of the three territories. All patients were assessed for atherosclerotic disease in the three territories. Coronary atherosclerosis was excluded by angioCT scan (calcium score=0 and no soft plaques) in controls, or confirmed in case of obstructive CAD on invasive coronary angiography (≥50% for the left main, ≥70% for other epicardial vessels). Obstructive carotid and inferior limbs atherosclerosis (≥50% stenosis) was assessed by Doppler or angioCT imaging. Acute atherosclerotic events or coronary revascularization within 12 months, heart failure, concomitant inflammatory diseases (such as infections or malignancy) and severe renal dysfunction were exclusion criteria. Clinical and laboratorial data were prospectively collected. Serum was stored at -80ºC and sCD40L measurements were performed in a blinded fashion, by ELISA (sCD40L Human Quantikine®).</p> <p><strong>Results:</strong> Sixty-three participants were recruited (Fig. 1A). Classical cardiovascular risk factors were globally more prevalent in patients with atherosclerosis comparing to controls. Regarding inflammation, the levels of sCD40L differed across groups (Fig. 1A), while the leucocytes and neutrophils counts, and c-reactive protein levels did not. sCD40L levels were significantly higher in patients with CAD without inferior limbs atherosclerosis comparing with controls; there was a trend for even higher sCD40L levels in patients with concomitant coronary and inferior limbs atherosclerosis (irrespectively of carotid territory) (Fig. 1B). On the contrary, there was no further increase in sCD40L levels in patients with concomitant carotid atherosclerosis and CAD comparing to patients with isolated CAD (Fig. 1C).</p> <p><strong>Conclusions: </strong>The absence of atherosclerotic disease, isolated CAD and multiterritorial disease were associated with a stepwise increase in sCD40L expression, respectively. A differential activation pattern of sCD40L was observed in inferior limbs and carotid atherosclerosis, in patients with CAD.</p>
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