sICAM-1 concentrations are associated with inflammation in contralateral carotid plaque in patients with ischemic stroke

Atherosclerotic plaques in the internal carotid artery are responsible for more than 15% of ischemic strokes. Carotid 18F-fluorodeoxyglucose positron emission tomography (18F-FDG PET) detects plaque inflammation. Plasma ICAM-1 and LRP1 concentrations have been associated with inflammation in ipsilateral carotid plaque. The aim of the present study was to test the association between the soluble (s) form of these biomarkers and contralateral carotid plaques. Prospective study conducted in 53 patients with a recent ischemic stroke and at least one atherosclerotic plaque in both carotid arteries. All of the patients underwent an early carotid 18F-FDG PET, and a blood sample was obtained at 7 ± 1 days. Several plasma inflammatory markers were evaluated by Multiplex and sLRP1 levels were measured by commercial ELISA. Bivariate and multivariable linear regression was used to assess the association between inflammatory markers and the clinical variables, including contralateral maximum standardized uptake value (SUVmax) and mean SUVmax (mean of contralateral and ipsilateral SUVmax) of 18F-FDG uptake. Hazard ratio (HR) was estimated with Cox models adjusted for potential confounding factors to evaluate recurrence. Multivariable linear regression analysis showed an independent association between sICAM-1 and sVCAM-1 and mean SUVmax (CI = −0.064–0.325, p = 0.004; CI = 0.079–0.554, p = 0.010). In addition, in bivariate regression analysis, sICAM-1 was associated with contralateral SUVmax (CI = 0.049–0.382, p = 0.012). Cox regression showed that mean SUVmax was associated with stroke recurrence (HR = 5.604, p = 0.044). sICAM-1 was independently associated with mean carotid plaque inflammation and with inflammation in contralateral plaque. sICAM-1 could be an indicator of plaque inflammation even in asymptomatic plaques. Las placas ateroscleróticas en la arteria carótida causan más del 15% de ictus isquémicos. La tomografía carotídea por emisión de positrones con 18F-fluorodesoxiglucosa (18F-FDG PET) detecta inflamación de la placa. La concentración plasmática de ICAM-1 y LRP1 se ha asociado con inflamación en placa ipsilateral. El objetivo del estudio fue estudiar la asociación entre la forma soluble (s) de estos biomarcadores y las placas carotídeas contralaterales. Estudio prospectivo de 53 pacientes con ictus isquémico reciente y al menos una placa aterosclerótica en ambas carótidas. A los pacientes se les realizó 18F-FDG PET y se obtuvo sangre entre los 7 ± 1 días. Se evaluaron biomarcadores inflamatorios por Multiplex y los niveles de sLRP1 mediante ELISA. Se evaluó mediante regresión lineal bivariable y multivariable la asociación entre los biomarcadores y las variables clínicas, incluido el valor máximo de captación estandarizado contralateral (SUVmáx) y el SUVmáx medio (media decontralateral e ipsilateral). El índice de riesgo de recurrencia (HR) se estimó con modelos Cox. La regresión multivariable mostró la asociación independiente entre sICAM-1 y sVCAM-1 y SUVmáx medio (IC = −0,064-0,325; p = 0,004; IC = 0,079-0,554; p = 0,010). Además, en análisis de regresión bivariado, sICAM-1 se asoció con SUVmáx contralateral (IC = 0,049-0,382; p = 0,012). La regresión de Cox mostró que el SUVmáx medio se asoció con recurrencia del ictus (HR = 5,604; p = 0,044). sICAM-1 se asoció de forma independiente con la inflamación media de la placa carotídea y con la inflamación de la placa contralateral. sICAM-1 podría ser un indicador de inflamación de la placa incluso en placas asintomáticas.