Elevated soluble intercellular adhesion molecule-1 levels are associated with poor short-term prognosis in middle-aged patients with acute ischaemic stroke

Abstract

Background There is increasing evidence that cellular adhesion molecules (CAMs) play an important role in the pathophysiology of acute ischaemic stroke. We examined the prognostic value of soluble intercellular adhesion molecule-1 (sICAM-1) and soluble vascular cell adhesion molecule-1 (sVCAM-1) on in-hospital mortality in patients with ischaemic stroke. Methods We recruited 241 consecutive patients ≤ 65 years of age who were admitted with acute ischaemic stroke. Serum levels of sICAM-1 and sVCAM-1 were determined within 12 h from admission. Seventy-six subjects without evidence of cardiovascular disease, matched for age and sex, served as controls. Results Patients with acute ischaemic stroke had higher sICAM levels compared to controls [267 (220–325) versus 200 (179–225) ng/ml, p < 0.001]. Sixteen (6.6%) patients died during hospitalization. sICAM-1 and sVCAM-1 levels were significantly higher in patients who died compared to those who survived [370 (324–453) versus 260 (219–313) ng/ml, p < 0.001 and 790 (495–985) versus 576 (494–671) ng/ml, p = 0.01, respectively] but only sICAM-1 levels were independently associated with early death, after adjusting for various confounding factors. For 10 ng/ml increase in sICAM-1 levels there was a 9% higher risk of dying. Cut-off point analysis revealed that sICAM-1 levels > 322 ng/ml were the optimal points that discriminated those who died from the rest of the patients. Conclusions High sICAM-1 levels on admission are associated with early death in ischaemic middle-aged stroke patients suggesting a pathogenetic role of inflammation in the evolution of ischaemic stroke.