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Background Coronary artery disease (CAD) is a major cause of death worldwide.Recently, studies have disclosed soluble CD40 ligand (sCD40L), one of the inflammatory markers, in atherosclerosis development and plaque destabilization.However, the association between sCD40L and angiographic severity of atherosclerotic disease in acute coronary syndrome (ACS) is yet to be determined.Therefore, the objective of the present study was to test the hypothesis that sCD40L levels are higher in ACS patients with a greater extent of angiographic coronary involvement.