Literature DB >> 21757661

Activated leukocyte cell adhesion molecule and prognosis in acute ischemic stroke.

Linda Smedbakken1, Jesper K Jensen, Jonas Hallén, Dan Atar, James L Januzzi, Bente Halvorsen, Pål Aukrust, Thor Ueland.   

Abstract

BACKGROUND AND
PURPOSE: Biomarkers predicting mortality and functional outcome in stroke may be clinically helpful in identification of patients likely to benefit from intervention. Activated leukocyte cell adhesion molecule (ALCAM) is upregulated during neuroinflammation; we investigated whether ALCAM concentrations are associated with long-term mortality after ischemic stroke.
METHODS: In 244 patients with acute ischemic stroke (age 69±13 years), samples of ALCAM were obtained serially from presentation to Day 5 and after 6 months. Patients with overt ischemic heart disease and atrial fibrillation were excluded. The patients were followed for 47 months with all-cause and cardiovascular mortality as end points.
RESULTS: At follow-up, 72 patients (29%) had died, 43 due to cardiovascular causes. Patients with ALCAM in the fourth quartile (>46.8 ng/mL) at admission had a significantly poorer survival rate on univariate analysis (P<0.001); other time points did not add further but provided similar prognostic information. In multivariate analysis, after adjustment for age, stroke severity, C-reactive protein levels, troponin T levels, and heart and/or renal failure, ALCAM levels above the fourth quartile remained an independent predictor of long-term mortality (adjusted hazard ratio, 2.05; 95% CI, 1.11 to 3.76; P=0.021) and cardiovascular mortality (adjusted hazard ratio, 2.54; 95% CI, 1.06 to 6.07; P=0.028).
CONCLUSIONS: ALCAM levels measured at admission of acute ischemic stroke are associated with long-term mortality.

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Year:  2011        PMID: 21757661     DOI: 10.1161/STROKEAHA.110.612440

Source DB:  PubMed          Journal:  Stroke        ISSN: 0039-2499            Impact factor:   7.914


  10 in total

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  10 in total

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