L1 cell adhesion molecule: a novel potential biomarker for infective endocarditis patients at high risk of embolism and adverse events.

Abstract

Aims: Despite advancements in medical and surgical therapies, infective endocarditis (IE) remains life-threatening owing to its complications. This study aimed to evaluate the clinical value and function of L1 cell adhesion molecule (L1CAM) in IE.

Methods: A prospective observational study including 94 IE patients (40 with embolic events [EEs], 54 without; 38 with adverse events, 56 without) and 25 healthy controls was conducted. Adverse events were defined as death or poorly controlled conditions requiring surgery. Plasma L1CAM levels were measured using enzyme-linked immunosorbent assays. Logistic regression and receiver operating characteristic curves were used to assess the predictive value of L1CAM levels for EEs and adverse events.

Results: L1CAM levels were higher in IE patients than in healthy controls (47.60 ± 10.86 vs. 94.80 ± 68.84 pg/mL, P = 0.008). Among IE patients, those with EEs or adverse events had significantly elevated L1CAM levels (EEs: 127.70 ± 78.20 vs. 70.45 ± 48.96 pg/mL; adverse events: 129.00 ± 79.79 vs. 71.59 ± 48.73 pg/mL, both P < 0.001). Multivariate analysis showed L1CAM level was an independent predictor for EEs (OR = 1.02; 95% CI = 1.01-1.04; P = 0.001) and adverse events (OR = 1.01; 95% CI = 1.00-1.02; P = 0.003). Areas under the curve were 0.7273 and 0.7119 for EEs and adverse events, respectively. L1CAM correlated positively with white blood cell count (P = 0.028, r = 0.225) and C-reactive protein levels (P = 0.025, r = 0.231).

Conclusions: L1CAM may serve as a biomarker for embolism and adverse events in IE patients.