title: High-sensitivity C-reactive protein is a strong risk factor for death after acute ischemic stroke among Chinese.
abstract: OBJECTIVE
  Elevated plasma C-reactive protein (CRP) has been suggested as a risk factor for ischemic stroke (IS) and coronary ischemic disease. Evidence has shown that high-sensitivity CRP (hs-CRP) is related to a worsening prognosis after IS, but hs-CRP was rare in a large-sample study in a Chinese population. We investigated the associations between hs-CRP and outcome of Chinese patients after acute IS.
  
  
  METHODS
  Seven hundred and forty-one consecutive acute IS patients (74.9% male, mean age 60.9 years), with baseline characteristics and hs-CRP measured within 24 h after hospitalization, were admitted in this study. We also prospectively followed up for clinical outcome and death 3 months after disease onset. hs-CRP was divided into two categories: hs-CRP >3 mg/L and hs-CRP ≤3 mg/L. Survival analysis using multivariable Cox regression was performed to analyze the association between hs-CRP and stroke outcomes after adjusting for potential confounding factors.
  
  
  RESULTS
  Compared with low hs-CRP, patients with high hs-CRP (>3 mg/L) had a significantly higher rate of all-cause death (0.71% vs. 10.00%; P < 0.001) at 3 months after stroke onset. High hs-CRP was an independent risk factor for all-cause death (HR, 6.48; 95% CI, 1.41 to 29.8; P= 0.016), as well as history of atrial fibrillation (HR, 5.24; 95% CI, 1.83 to 15.0; P= 0.002), no statin therapy during hospitalization (HR, 4.56; 95% CI, 2.18 to 9.55; P < 0.001), high homocysteine (>15.1 mmol/L) (HR, 2.66; 95% CI, 1.26 to 5.60; P= 0.01); fasting glucose (>6.1 mmol/L) (HR, 9.14; 95% CI, 3.34 to 25.0; P < 0.001), NIHSS at admission (HR, 2.35; 95% CI, 1.35 to 4.09; P= 0.003) and history of coronary heart disease (CHD) (HR, 2.34; 95% CI, 1.06 to 5.17; P= 0.035). Kaplan-Meier survival curves showed a higher risk of death for patients with hs-CRP >3 mg/L (P= 0.016).
  
  
  CONCLUSIONS
  Elevated plasma hs-CRP independently predicted risk of all-cause death within 3 months after acute IS in Chinese patients.
authors.affiliation: Department of Orthopedic Surgery - Campbell Clinic and Pathology, University of Tennessee Health Science Center (UTHSC), Memphis, TN 38163, USA.
authors.forename: Yue
authors.initials: Y
authors.lastname: Huang
authors.forename: Jing
authors.initials: J
authors.lastname: Jing
authors.forename: Xing-Quan
authors.initials: XQ
authors.lastname: Zhao
authors.forename: Chun-Xue
authors.initials: CX
authors.lastname: Wang
authors.forename: Yi-Long
authors.initials: YL
authors.lastname: Wang
authors.forename: Gai-Fen
authors.initials: GF
authors.lastname: Liu
authors.forename: Chun-Juan
authors.initials: CJ
authors.lastname: Wang
authors.forename: Li-Ping
authors.initials: LP
authors.lastname: Liu
authors.forename: Xiao-Meng
authors.initials: XM
authors.lastname: Yang
authors.forename: Yan
authors.initials: Y
authors.lastname: Jiao
authors.forename: Yun
authors.initials: Y
authors.lastname: Jiao
authors.forename: Li-Shi
authors.initials: LS
authors.lastname: Wang
authors.forename: Yong-Jun
authors.initials: YJ
authors.lastname: Wang
authors.forename: Wei-Kuan
authors.initials: WK
authors.lastname: Gu
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D044466:Asian People / Q000208:ethnology; D015415:Biomarkers / Q000097:blood; D002545:Brain Ischemia / Q000097:blood* / Q000208:ethnology / Q000401:mortality*; D002097:C-Reactive Protein / Q000378:metabolism*; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D008875:Middle Aged; D012307:Risk Factors; D020521:Stroke / Q000097:blood* / Q000208:ethnology / Q000401:mortality*; D015996:Survival Rate / Q000639:trends
chemical_list: D015415:Biomarkers; D002097:C-Reactive Protein