• Leonardo Lorente, María M Martín, Agustín F González-Rivero, Luis Ramos, Mónica Argueso, Juan J Cáceres, Jordi Solé-Violán, Alejandro Jiménez, and Juan M Borreguero-León.
• Intensive Care Unit, Hospital Universitario de Canarias, La Laguna 38320, Spain. lorentemartin@msn.com.
• Int J Mol Sci. 2015 May 28; 16 (6): 12147-58.

BackgroundCD154 and its soluble counterpart (sCD154) are proteins of the tumor necrosis factor (TNF) family and exhibit proinflamatory and procoagulant properties. Higher circulating sCD154 levels have been found in ischemic stroke patients than in controls. However, the association between circulating sCD154 levels and mortality in ischemic stroke patients has not been reported, and was the focus of this study.MethodsThis was a multicenter, observational and prospective study carried out in six Spanish Intensive Care Units. We measured serum sCD154 from 50 patients with severe malignant middle cerebral artery infarction (MMCAI), defined as Glasgow Coma Scale (GCS) lower than 9, at the moment of the severe MMCAI diagnosis and from 50 healthy controls. The end-point of the study was 30-day mortality.ResultsWe found higher serum sCD154 levels in patients with severe MMCAI than in healthy controls (p < 0.001). We found higher serum sCD154 levels (p < 0.001) in non-surviving (n = 26) than in surviving MMCAI patients (n = 24). Multiple binomial logistic regression analysis showed that serum sCD154 levels >1.41 ng/mmL were associated with 30-day mortality (OR = 10.25; 95% CI = 2.34-44.95; p = 0.002).ConclusionsThe new more important finding of our study was that serum sCD154 levels in MMCAI patients were associated with mortality.

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