title: C-reactive protein predicts further ischemic events in transient ischemic attack patients.
abstract: OBJECTIVE
  Although patients with transient ischemic attack (TIA) experience cardiovascular events frequently, strong clinical predictors of recurrence are lacking. High-sensitivity C-reactive protein (hs-CRP) has been shown to be a powerful predictor of future first-ever and recurrent coronary and cerebral ischemic events. We aimed to investigate the relationship between hs-CRP and the risk of further ischemic events in TIA patients.
  
  
  METHODS
  High-sensitivity C-reactive protein level was determined <24 h after symptom onset among 135 consecutive TIA patients and stroke recurrence or any new vascular event was recorded during 1 year follow-up period.
  
  
  RESULTS
  A total of 38 (28.1%) patients experienced an end point event: 28 (20.7%) cerebral ischemic events, six (4.4%) heart ischemic events, four (3%) peripheral arterial disease, and nine (6.7%) vascular deaths. Cox proportional hazards multivariate analyses identified age [hazard ratio (HR) 1.07, 95% confidence interval (CI) 1.01-1.12, P = 0.01], large-artery occlusive disease (HR 2.73, 95% CI 1.16 to 6.41, P = 0.02) and hs-CRP> 4.1 mg/l (HR 2.81, 95% CI 1.12-7.10, P = 0.03) as independent predictors of stroke. Moreover, age (HR 1.05, 95% CI 1.01-1.10, P = 0.02), large-artery occlusive disease (HR 3.12, 95% CI 1.48-6.58, P < 0.01), coronary disease (HR 2.39, 95% CI 1.11-5.16, P = 0.03), and hs-CRP> 4.1 mg/l (HR 2.71, 95% CI 1.16-6.30, P = 0.02) were also independent predictors of any vascular event.
  
  
  CONCLUSIONS
  High-sensitivity C-reactive protein serum level predicts further ischemic events following TIA. Routine CRP measurement might be a useful tool for identifying high-risk TIA patients in order to plan aggressive diagnostic protocols and prevention therapies.
authors.affiliation: Department of Neurology, Universitat de Lleida, Hospital Universitari Arnau de Vilanova, Irblleida, Lleida, Spain. 34271fpg@comb.es
authors.forename: F
authors.initials: F
authors.lastname: Purroy
authors.forename: J
authors.initials: J
authors.lastname: Montaner
authors.forename: C A
authors.initials: CA
authors.lastname: Molina
authors.forename: P
authors.initials: P
authors.lastname: Delgado
authors.forename: J F
authors.initials: JF
authors.lastname: Arenillas
authors.forename: P
authors.initials: P
authors.lastname: Chacon
authors.forename: M
authors.initials: M
authors.lastname: Quintana
authors.forename: J
authors.initials: J
authors.lastname: Alvarez-Sabin
mesh_terms: D000367:Age Factors; D000368:Aged; D000369:Aged, 80 and over; D015415:Biomarkers / Q000097:blood; D002097:C-Reactive Protein / Q000378:metabolism*; D005500:Follow-Up Studies; D006801:Humans; D002546:Ischemic Attack, Transient / Q000097:blood*; D008875:Middle Aged; D011446:Prospective Studies; D012008:Recurrence; D018570:Risk Assessment; D020521:Stroke / Q000097:blood*
chemical_list: D015415:Biomarkers; D002097:C-Reactive Protein