Soluble intercellular adhesion molecule-1 and risk of future ischemic stroke - A nested case-control study from the Bezafibrate Infarction Prevention (BIP) study cohort

Background and Purpose-Inflammation is considered to be involved in the pathogenesis of ischemic stroke Our purpose was to assess the role of soluble intercellular adhesion molecule 1 (sICAM 1) concentration a marker of inflammation in predicting future ischemic stroke among patients at risk because of chronic coronary heart disease Methods-We obtained baseline serum samples from patients with chronic coronary heart disease enrolled in the Bezafibrate Infarction Prevention trial (n=3090) which assessed the efficacy of bezafibrate in secondary prevention Using a prospective nested case control design we measured baseline sICAM 1 concentration in sera of patients who developed ischemic stroke during a mean follow up of 8 2 years (cases n = 134) and in age and sex matched controls without any subsequent cardiovascular events (n = 134) Results-Baseline serum concentrations of sICAM 1 were significantly higher in cases compared with controls (379 versus 350 ng/mL P(<0 05) sICAM 1 concentration at the highest quartile (> 194 ng/mL) was associated with significantly higher relative odds of ischemic stroke compared with the lower concentrations after adjustment for potential confounding variables (relative odds 2 1 95% CI 1 1 to 4 3) After fibrinogen and total white blood cell count were added to the multivariable model the relative odds were 2 1 (95% CI 1 1 to 4 2) and 2 2 (95% CI 1 1 to 4 8) respectively The risk associated with raised concentrations of sICAM I seemed to be highest for large disabling strokes of cardioembolic origin Conclusions-Elevated concentrations of sICAM 1 a marker of inflammation are associated with increased risk of ischemic stroke independent of other traditional cerebrovascular risk factors and of plasma fibrinogen among patients at increased risk because of manifest coronary heart disease.