Soluble CD40 ligand and interleukin-6 in the coronary circulation after acute myocardial infarction

Int J Cardiol. 2006 Sep 10;112(1):52-8. doi: 10.1016/j.ijcard.2005.09.051. Epub 2006 Jan 10.


Background: Inflammation, operated by blood, vascular and immune cells interaction, is implicated in plaque disruption and CD40 ligand (CD40L) was identified on activated T cells and platelets. We sought to investigate the roles of local inflammation in acute myocardial infarction (AMI).

Methods: Coronary sinus (CS) and arterial (A) levels of interleukin (IL)-6 and soluble CD40L (sCD40L) and matrix metalloproteinase (MMP)-9 activity in serial blood samples obtained until 48 h after percutaneous coronary intervention (PCI) were determined. In tissue specimens obtained by aspirating thrombectomy and directional coronary atherectomy, CD40L was immunohistochemically stained.

Results: Trans-cardiac gradient (CS-A) of IL-6, indicating cardiac release into the coronary circulation, significantly increased at 24 h after PCI in patients with AMI (group MI, n=17) in contrast with angina pectoris (n=10). Soluble CD40L levels in CS showed earlier peak, yielding trans-cardiac gradient, at 9 h in both groups. The maximum (max) release of IL-6 in MI, but not sCD40L, positively correlated with end-diastolic volume index (R=0.84) and negatively with ejection fraction (R=-0.66) by contrast ventriculography at 6-month follow up. Immunohistological study revealed the expression of CD40L in intra-coronary occlusive and mural thrombi. Aspirating thrombectomy significantly reduced the increase in both sCD40L levels and MMP-9 activity, but not max IL-6 release in MI.

Conclusions: In contrast with myocardial injury represented by IL-6 release, acute rise in sCD40L levels with the MMP-9 activation in the coronary circulation may possibly reflect local inflammation with platelet activation and be a novel marker of plaque damage by PCI.

Publication types

  • Comparative Study
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Aged
  • Angina Pectoris / blood
  • Angina Pectoris / physiopathology
  • Angioplasty, Balloon, Coronary
  • Atherectomy, Coronary
  • Biomarkers / blood
  • C-Reactive Protein / metabolism
  • CD40 Ligand / metabolism*
  • Coronary Circulation*
  • Coronary Thrombosis / blood
  • Coronary Thrombosis / physiopathology
  • Creatine Kinase, MB Form / metabolism
  • Female
  • Follow-Up Studies
  • Humans
  • Immunohistochemistry
  • Interleukin-6 / metabolism*
  • Male
  • Matrix Metalloproteinase 9 / metabolism*
  • Middle Aged
  • Myocardial Infarction / blood*
  • Myocardial Infarction / physiopathology*
  • Myocardial Infarction / therapy
  • Myocarditis / blood
  • Myocarditis / physiopathology
  • Stroke Volume
  • Thrombectomy
  • Treatment Outcome


  • Biomarkers
  • Interleukin-6
  • CD40 Ligand
  • C-Reactive Protein
  • Creatine Kinase, MB Form
  • Matrix Metalloproteinase 9