title: Association between Serum Soluble CD154 Levels and Mortality in Patients with Malignant Middle Cerebral Artery Infarction.
abstract: BACKGROUND
  CD154 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.
  
  
  METHODS
  This 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.
  
  
  RESULTS
  We 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).
  
  
  CONCLUSIONS
  The new more important finding of our study was that serum sCD154 levels in MMCAI patients were associated with mortality.
authors.affiliation: Intensive Care Unit, Hospital Universitario de Canarias, La Laguna 38320, Spain. lorentemartin@msn.com.
authors.forename: Leonardo
authors.initials: L
authors.lastname: Lorente
authors.affiliation: Intensive Care Unit, Hospital Universitario Nuestra Señora de Candelaria, Santa Cruz de Tenerife 38010, Spain. mar.martinvelasco@gmail.com.
authors.forename: María M
authors.initials: MM
authors.lastname: Martín
authors.affiliation: Laboratory Deparment, Hospital Universitario de Canarias, La Laguna 38320, Spain. tinofran@hotmail.com.
authors.forename: Agustín F
authors.initials: AF
authors.lastname: González-Rivero
authors.affiliation: Intensive Care Unit, Hospital General La Palma, Breña Alta 38713, Spain. lramosgomez@gmail.com.
authors.forename: Luis
authors.initials: L
authors.lastname: Ramos
authors.affiliation: Intensive Care Unit, Hospital Clínico Universitario de Valencia, Valencia 46004, Spain. moni_begasa@hotmail.com.
authors.forename: Mónica
authors.initials: M
authors.lastname: Argueso
authors.affiliation: Intensive Care Unit, Hospital Insular, Las Palmas de Gran Canaria 35016, Spain. juanjose.caceresagra@gobiernodecanarias.org.
authors.forename: Juan J
authors.initials: JJ
authors.lastname: Cáceres
authors.affiliation: Intensive Care Unit, Hospital Universitario Dr. Negrín, Las Palmas de Gran Canaria 35010, Spain. jsolvio@gobiernodecanarias.org.
authors.forename: Jordi
authors.initials: J
authors.lastname: Solé-Violán
authors.affiliation: Research Unit, Hospital Universitario de Canarias, La Laguna 38320, Spain. ajimenezsosa@gmail.com.
authors.forename: Alejandro
authors.initials: A
authors.lastname: Jiménez
authors.affiliation: Laboratory Deparment, Hospital Universitario de Canarias, La Laguna 38320, Spain. jmborreguero@hotmail.com.
authors.forename: Juan M
authors.initials: JM
authors.lastname: Borreguero-León
mesh_terms: D000328:Adult; D000368:Aged; D014408:Biomarkers, Tumor / Q000097:blood*; D023201:CD40 Ligand / Q000097:blood*; D016022:Case-Control Studies; D005260:Female; D006801:Humans; D020244:Infarction, Middle Cerebral Artery / Q000097:blood* / Q000401:mortality* / Q000473:pathology; D016015:Logistic Models; D008297:Male; D008875:Middle Aged; D011379:Prognosis; D011446:Prospective Studies
chemical_list: D014408:Biomarkers, Tumor; D023201:CD40 Ligand
keywords: cerebral infarction; mortality; patients; sCD154