Prognostic value of admission C-reactive protein in stroke patients undergoing iv thrombolysis.
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.
Topakian
Raffi
R
Dept. of Neurology, Academic Teaching Hospital, Wagner-Jauregg, Wagner-Jauregg-Weg 15, 4020, Linz, Austria. raffi.topakian@hotmail.com
Strasak
Alexander M
AM
Nussbaumer
Karin
K
Haring
Hans-Peter
HP
Aichner
Franz T
FT
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
D002097:C-Reactive Protein