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.0000000000000806 | DOI Listing |
J Neurol
January 2025
Department of Neurology, Heidelberg University Hospital, Heidelberg, Germany.
Background And Purpose: Endothelial dysfunction is considered an emerging therapeutic target to prevent complications during acute stroke and to prevent recurrent stroke. This review aims to provide an overview of the current knowledge on endothelial dysfunction, outline the diagnostic methods used to measure it and highlight the drugs currently being investigated for the treatment of endothelial dysfunction in acute ischemic stroke.
Methods: The PubMed® and ClinicalTrials.
Drug Des Devel Ther
January 2025
Department of Critical Care Medicine, Chengdu Pidu District Hospital of Traditional Chinese Medicine, Chengdu, Sichuan Province, 611731, People's Republic of China.
Cerebral ischemia-reperfusion injury (CIRI) is clinically characterized by high rates of morbidity, disability, mortality, and recurrence as well as high economic burden. The clinical manifestations of CIRI are often accompanied by gastrointestinal symptoms such as intestinal bacterial dysbiosis and gastrointestinal bleeding. Gut microbiota plays an important role in the pathogenesis of CIRI, and its potential biological effects have received extensive attention.
View Article and Find Full Text PDFNeurology
February 2025
Department of Neurology, Yale University School of Medicine, New Haven, CT.
Background And Objectives: The most effective antiseizure medications (ASMs) for poststroke seizures (PSSs) remain unclear. We aimed to determine outcomes associated with ASMs in people with PSS.
Methods: We systematically searched electronic databases for studies on patients with PSS on ASMs.
Radiologie (Heidelb)
January 2025
Klinik für Diagnostische und Interventionelle Neuroradiologie, Kirrberger Straße, Gebäude 90, 66421, Homburg/Saar, Deutschland.
Background: The treatment of strokes is based on two pillars: the efficient management of acute strokes to minimize permanent neurological deficits, and secondary prevention to avoid recurrence.
Objective: To summarize current recommendations for secondary stroke prevention.
Materials And Methods: Guidelines and recent studies on the most common causes of strokes, and their treatment and prevention are reviewed.
J Chin Med Assoc
January 2025
Institute of Clinical Medicine, National Yang Ming Chiao Tung University, Taipei, Taiwan, ROC.
Cerebral autosomal dominant arteriopathy with subcortical infarcts and leukoencephalopathy (CADASIL) is the most common hereditary cerebral small vessel disease caused by mutations in the NOTCH3 gene. This review highlights the increasing recognition of intracerebral hemorrhage (ICH) as a significant manifestation of CADASIL, often predominantly characterized by ischemic strokes and vascular dementia. Recent studies indicate that the prevalence of ICH in CADASIL patients ranges from 0.
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