C-reactive protein and fibrinogen in acute stroke patients with and without sleep apnea.
OBJECTIVE
Although sleep apnea (SA) is a risk factor for ischemic stroke and an important prognosticator in affected patients, the exact pathophysiological link between SA and stroke remains to be established. We investigated whether levels of C-reactive protein (CRP) and fibrinogen are increased in patients with acute stroke and SA compared with stroke patients without SA.


METHODS
117 consecutive patients with ischemic stroke admitted to our stroke unit within 12 h after stroke onset were included in this study. On admission, CRP and fibrinogen levels were determined. All patients received cardiorespiratory polygraphy during the first 72 h of their hospital stay. In all patients, demographic data, National Institutes of Health Stroke Scale score and cerebrovascular risk factors were assessed.


RESULTS
SA defined by an apnea-hypopnea index (AHI) of > or =10/h was found in 64 (55%) patients. Elevated CRP and fibrinogen levels were seen twice as often in patients with SA than in patients without (CRP: 52 vs. 26%; fibrinogen: 72 vs. 37%). After multivariate logistic regression analysis, an AHI of > or =10/h was independently correlated with raised levels of both of these parameters.


CONCLUSIONS
SA is independently associated with raised levels of CRP and fibrinogen in patients with acute ischemic stroke. We assume that both proteins are part of the pathophysiological pathway linking SA to stroke.
Dziewas
Rainer
R
Department of Neurology, University Hospital of Munster, Munster, Germany. dziewas@uni-muenster.de
Ritter
Martin
M
Kruger
Linn
L
Berger
Stefanie
S
Langer
Claus
C
Kraus
Jorg
J
Dittrich
Ralf
R
Schabitz
Wolf R
WR
Ringelstein
E Bernd
EB
Young
Peter
P
D000208:Acute Disease; D000368:Aged; D002097:C-Reactive Protein / Q000378:metabolism*; D003430:Cross-Sectional Studies; D005260:Female; D005340:Fibrinogen / Q000378:metabolism*; D006801:Humans; D016015:Logistic Models; D008297:Male; D008875:Middle Aged; D016017:Odds Ratio; D011446:Prospective Studies; D018570:Risk Assessment; D012307:Risk Factors; D012720:Severity of Illness Index; D012891:Sleep Apnea Syndromes / Q000097:blood* / Q000150:complications; D020521:Stroke / Q000097:blood* / Q000209:etiology
D005340:Fibrinogen; D002097:C-Reactive Protein