Soluble intercellular adhesion molecule-1 in patients with recent cerebral ischemic events
Objective: To determine whether serum levels of soluble intercellular adhesion molecule-1 (sICAM) differ between individuals with recent acute ischemic stroke (AIS) or transient ischemic attack (TIA) and control subjects. Methods: sICAM levels were measured in patients with recent (≤ 7 days) AIS or TIA and in patients with asymptomatic carotid stenosis and control subjects. Demographic information was collected and all subjects underwent complete neurological evaluations, routine blood tests and baseline cervical ultrasonography. Subjects with either a qualifying AIS or TIA also underwent cranial CT. sICAM levels were compared between different patient groups and correlated with carotid stenosis in those with AIS or TIA using analysis of variance (ANOVA) and logistic regression. Results: sICAM levels were measured in 288 patients (48.6% males). Of these, 91 had either a recent AIS or TIA. There were 75 control subjects. The remainder (n=122) had an asymptomatic carotid stenosis. Mean follow-up for all patients was 25.1 months. Mean age and distribution of cardiovascular risk factors were similar across all groups of patients. Mean sICAM levels were higher in those with recent AIS or TIA than in control subjects but without quite reaching statistical significance (p=0.10). For those with either AIS or TIA, mean sICAM levels did not differ on repeat measurement nor did initial levels correlate with the degree of carotid stenosis homolateral to the side of the ischemic event. During follow-up, 30 patients overall, (10.4%), experienced a recurrent ischemic event (either TIA, AIS, myocardial infarction and/or vascular death). Patients with either AIS or TIA, experienced a higher recurrence rate (24.6%). Mean sICAM levels were higher in those patients with a recurrent ischemic event (375.9 ng/mL) than in those without (332.1 ng/mL). Conclusion: There was a trend for higher sICAM levels in patients with recent AIS or TIA compared with control subjects. In addition, higher initial sICAM levels were associated with an increased risk of recurrent ischemic events for all patients.