title: Prognostic value of admission C-reactive protein in stroke patients undergoing iv thrombolysis.
abstract: OBJECTIVE
  To test the hypothesis that pre-treatment Creactive protein (CRP) predicts outcome in stroke patients undergoing intravenous thrombolysis (IVT) treatment.
  
  
  METHODS
  We analyzed the data of 111 consecutive patients with IVT within 6 hours of stroke onset for stroke involving the middle cerebral artery territory and admission CRP < or = 6 mg/dl.
  
  
  RESULTS
  CRP levels were consistently, yet non-significantly lower in patients with unfavourable outcome definitions. Median (range) CRP levels were 0.3 (0-5.9) mg/dl vs. 0.4 (0-5.7) mg/dl (p = 0.13) in patients dependent or dead after 3 months (modified Rankin Scale score > 2; n = 59) vs. independent patients (n = 52); 0.2 (0.1-1.5) mg/dl vs. 0.4 (0-5.9) mg/dl (p = 0.28) in patients dead after 3 months (n = 14) versus survivors (n = 97); and 0.2 (0.1-0.7) mg/dl vs. 0.4 (0-5.9) mg/dl (p = 0.09) in patients with significant neurological deterioration within 24 hours (increase in > or = 4 points on National Institute of Health Stroke scale; n = 9) vs. patients without early deterioration (n = 102). Independent predictors of dependency/death after 3 months, identified by multivariate logistic regression analyses, were baseline NIHSS score (OR = 1.31, 95 % CI 1.16-1.48, p < 0.001), time from onset to treatment (OR = 1.01, 95 % CI 1.0-1.02, p = 0.024), and presence of diabetes (OR = 8.16, 95 % CI 1.18-56.5, p = 0.033).
  
  
  CONCLUSIONS
  Pre-treatment CRP clearly failed to predict outcome in stroke patients treated with IVT. Our findings contradict previously published work and highlight the need for further research on this topic.
authors.affiliation: Dept. of Neurology, Academic Teaching Hospital, Wagner-Jauregg, Wagner-Jauregg-Weg 15, 4020, Linz, Austria. raffi.topakian@hotmail.com
authors.forename: Raffi
authors.initials: R
authors.lastname: Topakian
authors.forename: Alexander M
authors.initials: AM
authors.lastname: Strasak
authors.forename: Karin
authors.initials: K
authors.lastname: Nussbaumer
authors.forename: Hans-Peter
authors.initials: HP
authors.lastname: Haring
authors.forename: Franz T
authors.initials: FT
authors.lastname: Aichner
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D002097:C-Reactive Protein / Q000008:administration & dosage; D015331:Cohort Studies; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D009422:Nervous System Diseases / Q000209:etiology; D011237:Predictive Value of Tests; D012044:Regression Analysis; D012189:Retrospective Studies; D012720:Severity of Illness Index; D020521:Stroke / Q000150:complications / Q000175:diagnosis* / Q000188:drug therapy* / Q000401:mortality; D015912:Thrombolytic Therapy / Q000379:methods*; D013997:Time Factors; D016896:Treatment Outcome
chemical_list: D002097:C-Reactive Protein