Is there a prognostic role for C-reactive protein in ischemic stroke?
OBJECTIVE
We investigated the relationship between C-reactive protein (CRP)-values in the acute phase of stroke and the risk of further fatal and non-fatal ischemic events.


METHODS
We analysed 462 consecutive incident ischemic strokes. Patients were divided into two subgroups on the basis of a CRP cut-off level of 9 mg/l. Primary end points were any new vascular fatal and non-fatal event recorded during the follow-up period.


RESULTS
During a follow-up of 2.27 years, in 132 patients occurred a primary end point. Patients with CRP values > or = 9 mg/l had more frequently primary end point. The hazard ratio (HR) for cardiovascular events was 3.59; 1.93 for cerebrovascular events; 7.43 for vascular deaths and 5.78 for death from any cause. Cox proportional hazard multivariate analysis identified CRP values > or = 9 (HR = 4.19, 95% CI: 1.85-9.50, P = 0.001), the lack of secondary prevention therapy at discharge (HR = 4.35, 95% CI: 1.87-10.1, P = 0.001), age >70 years (HR = 3.09, 95% CI: 1.04-9.24, P = 0.04) as independent predictors of fatal events.


CONCLUSIONS
CRP levels > or = 9 mg/l, evaluated in incident ischemic stroke within 24 h, predict a higher risk of further ischemic events and mortality.
Corso
G
G
Department of Neurology, Ospedale Regionale, Aosta, Valle d'Aosta, Italy. gcorso@ausl.vda.it
Bottacchi
E
E
Brusa
A
A
Benedetto
M Di
MD
Giardini
G
G
Lia
C
C
Reggiani
M
M
Veronese Morosini
M
M
D000368:Aged; D002097:C-Reactive Protein / Q000378:metabolism*; D005260:Female; D006801:Humans; D053208:Kaplan-Meier Estimate; D008137:Longitudinal Studies; D008297:Male; D011379:Prognosis; D016016:Proportional Hazards Models; D012372:ROC Curve; D012189:Retrospective Studies; D020521:Stroke / Q000097:blood / Q000175:diagnosis / Q000401:mortality
D002097:C-Reactive Protein