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

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, pb0.001]. 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, pb0.001 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. (C) 2007 Elsevier Ireland Ltd. All rights reserved.