Association of serum TRAIL level with coronary artery disease

Tumor necrosis factor (TNF)-related apoptosis-inducing ligand (TRAIL) is a member of the TNF ligand family, and is able to induce apoptosis in tumor cells. Emerging experimental findings suggest the involvement of TRAIL in vascular biology and atherosclerosis. However, little is known concerning the role of TRAIL in atherosclerosis in humans. We therefore examined whether serum TRAIL levels are associated with coronary artery disease (CAD). Serum TRAIL levels were measured by ELISA in 285 patients who underwent coronary angiography. Serum TRAIL level was significantly lower in patients with CAD (659.2 ± 176.6 pg/ml) than in those without CAD (732.3 ± 187.9 pg/ml, p = 0.0016). Next, the number of diseased vessels was used to represent the severity of CAD. Serum TRAIL levels were inversely associated with the severity of CAD (p for trend = 0.0005). In particular, TRAIL levels in patients with severe 3-vessel disease were significantly lower than those in subjects without CAD (602.9 ± 150.0, 732.3 ± 187.9 pg/ml, respectively; p < 0.05). Multivariable logistic regression analysis revealed that serum TRAIL levels were significantly associated with the presence of CAD (odds ratio, 0.68; 95% confidence interval 0.51-0.90; p = 0.006). Serum TRAIL levels were inversely associated with the advanced CAD, suggesting that TRAIL may be useful as a biomarker of CAD severity.