Soluble CD40 ligand in acute coronary syndrome in cocaine users

Background and objectives: The soluble CD40 ligand (sCD40L) expressed on platelets is released in the activation process. We analyzed the sCD40L serum concentration in cocaine users with acute coronary syndrome (ACS). Patients and methods: Retrospective comparison of sCD40L serum concentration between 40 patients with ACS and a positive test for cocaine in urine and 40 ACS patients with a negative cocaine test. Results: The mean (SD) sCD40L serum concentration in the patients with ACS and a negative cocaine test was lower (110 [41.1] pg/mL) than in patients who were not cocaine users (65.3 pg/mL) (P=.03). In the multivariable analysis, after adjustment for age and coronary risk in these patients with ACS, a positive cocaine test remained associated with sCD40L concentration. Conclusions: The sCD40L plays a part in the proinflammatory thrombotic process in cocaine users who develop ACS. [Emergencias 2011;23:104-107].