Association of circulating high-sensitivity C-reactive protein with late recurrence after ischemic stroke.

Neuroreport

aDepartment of Neurosurgery, Shouguang City People's Hospital, Shouguang, Shandong Province bDepartment of Neurology, First Affiliated Hospital of Kunming Medical University, Kunming, Yunnan Province, China.

Published: July 2017

We investigated the association between serum levels of high-sensitivity C-reactive protein (hs-CRP) and stroke recurrence events in a cohort of patients with acute ischemic stroke (IS). We prospectively studied 286 patients with acute IS who were admitted within 24 h after the onset of symptoms. Serum levels of hs-CRP, and National Institutes of Health stroke scale (NIHSS) were measured at admission. The primary endpoint was stroke recurrence 1 year after stroke onset. We used logistic regression models to assess the relationship between hs-CRP levels and the risk of recurrent stroke. In multivariable models, hs-CRP levels were associated with an increased risk of an NIHSS greater than 6 [odds ratio=1.17; 95% confidence interval (CI)=1.05-1.48; P=0.021]. Among the participants, stroke recurrence was found in 48 (16.8%) cases. In multivariate analyses, the third and fourth quartiles of hs-CRP were significantly associated with stroke recurrence during the observation period compared with the first quartile group (P<0.01). In addition, the hs-CRP level in the highest quartile was associated with a higher risk of stroke recurrence (odds ratio=2.75; 95% CI=1.62-3.92; P=0.006). Hs-CRP (area under the curve=0.71; 95% CI=0.64-0.79) improved the ability of the NIHSS score to diagnose stroke recurrence (area under the curve of the combined model 0.78; 95% CI=0.73-0.84; P<0.01). Serum levels of hs-CRP at admission predicted the future stroke recurrence in patients with IS.

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http://dx.doi.org/10.1097/WNR.0000000000000806DOI Listing

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