CD4 and acute myocardial infarction: Earlier studies have shown that an increased level of TRAIL on the surface of CD4+ T cells was strongly correlated with plaque instability in carotid atheroma tissues (27); TRAIL exerted pleiotropic activation effects on endothelial cells, vascular smooth muscle cells, and inflammation cells (28); and low levels of TRAIL were linked to a poor prognosis in individuals with acute myocardial infarction, according to multiple clinical trials (29).