Abstract
OBJECTIVE: This study aimed to investigate the association between smoking and plasma levels of sCD40L, sP-selectin, and sICAM-1 in patients with coronary heart disease (CHD), and to evaluate their correlations with smoking intensity and coronary anatomical complexity assessed by the SYNTAX score. METHODS: We analyzed data from 244 patients with CHD undergoing percutaneous coronary intervention, categorized into smokers (n = 150) and nonsmokers (n = 94). Smoking intensity was quantified using the smoking index (SI). Plasma biomarker levels were measured via ELISA. SYNTAX scores I and II were assessed by two experienced interventional cardiologists to evaluate coronary lesion complexity. Group comparisons, Spearman's correlation adjusted with the Benjamini-Hochberg method, tests for interaction (Gender × Smoking Status), and multivariate regression models were employed. RESULTS: Smokers exhibited significantly higher sICAM-1 levels than nonsmokers (662.6 vs. 548.6 ng/ml, P = 0.007). sICAM-1 was an independent risk factor for CHD in smokers (OR = 1.001, 95% CI: 1.00003-1.033, P = 0.043). Strong correlations were observed among all three biomarkers (all P < 0.001). Subgroup analyses showed significant correlations between SI and all three biomarkers, and both SI and sP-selectin correlated positively with SYNTAX scores I and II (all P < 0.01). Formal interaction analysis indicated no significant effect modification by gender on the observed associations (all P >> 0.05). CONCLUSION: Elevated levels of sICAM-1, sCD40L, and sP-selectin are interrelated and associated with smoking intensity and coronary anatomical complexity, highlighting their role as key inflammatory mediators in smoking-related CHD.