title: Routine serum C-reactive protein and stroke outcome after intravenous thrombolysis.
abstract: OBJECTIVE
  The clinical usefulness of blood biomarkers in acute stroke is not yet fully established, especially after thrombolytic therapy. Our aim was to investigate the association between routine serum C-reactive protein (CRP) measured within 24 h after admission and outcome in ischaemic stroke patients treated with intravenous thrombolysis, adjusting for a history of recent infection.
  
  
  METHODS
  We analysed the data of consecutive stroke patients who received intravenous alteplase in our centre between October 2003 and December 2011, collected in a detailed prospective registry. Routine serum CRP was measured within 24 h from admission; concentration >5 ng/ml was considered elevated.
  
  
  RESULTS
  Serum CRP was measured in 341 of 406 stroke patients treated with alteplase. Patients with elevated CRP (135/341, 42.5%) compared to those with normal CRP values, were significantly older, more frequently presented with a preexisting disability, comorbidities and suffered more severe strokes. They had a higher proportion of symptomatic intracranial haemorrhage according to ECASS II definition (7.2% vs 1.6%, P = 0.010), higher 3-month mortality (25.6% vs 11.3%, P = 0.001), and were less frequently alive and independent after 3 months (45.9% vs 63.7%, P = 0.002). However, those associations were not confirmed after adjustment for age, stroke severity, diabetes, congestive heart failure, lack of prestroke disability and signs of recent infection.
  
  
  CONCLUSIONS
  According to our findings, elevated routine serum CRP measured within 24 h after admission does not seem to independently affect the outcome in patients receiving intravenous thrombolysis for stroke. However, further studies of blood samples taken directly before the treatment are needed.
authors.affiliation: 2nd Department of Neurology, Institute of Psychiatry and Neurology, Warsaw, Poland.
authors.forename: M
authors.initials: M
authors.lastname: Karlinski
authors.forename: J
authors.initials: J
authors.lastname: Bembenek
authors.forename: K
authors.initials: K
authors.lastname: Grabska
authors.forename: A
authors.initials: A
authors.lastname: Kobayashi
authors.forename: A
authors.initials: A
authors.lastname: Baranowska
authors.forename: T
authors.initials: T
authors.lastname: Litwin
authors.forename: A
authors.initials: A
authors.lastname: Czlonkowska
mesh_terms: D000368:Aged; D015415:Biomarkers / Q000097:blood*; D002097:C-Reactive Protein / Q000032:analysis*; D005260:Female; D005343:Fibrinolytic Agents / Q000627:therapeutic use; D006760:Hospitalization; D006801:Humans; D008297:Male; D011446:Prospective Studies; D020127:Recovery of Function; D012042:Registries; D012189:Retrospective Studies; D020521:Stroke / Q000097:blood* / Q000188:drug therapy* / Q000401:mortality; D015912:Thrombolytic Therapy / Q000379:methods*; D010959:Tissue Plasminogen Activator / Q000627:therapeutic use
chemical_list: D015415:Biomarkers; D005343:Fibrinolytic Agents; D002097:C-Reactive Protein; D010959:Tissue Plasminogen Activator
keywords: C-reactive protein; acute stroke; infection; ischaemic stroke; outcome; prognosis; thrombolysis