title: Prognostic Value of C-Reactive Protein and Homocysteine in Large-Artery Atherosclerotic Stroke: a Prospective Observational Study.
abstract: BACKGROUND
  Our objective is to investigate whether C-reactive protein (CRP) and homocysteine (Hcy) levels in the acute phase of large-artery atherosclerotic stroke predict long-term functional disability and recurrent vascular events.
  
  
  METHODS
  Patients with first-ever large-artery atherosclerotic ischemic stroke were prospectively registered in the Nanjing Stroke Registry Program between January 2012 and June 2014. Venous blood samples were collected within 2 weeks after the index stroke. Patients were followed up for 1 year. The Kaplan-Meier method was performed in survival analysis. Multiple logistic regression analysis and Cox proportional hazard model were applied to identify predictors of functional disability and recurrent vascular events, respectively.
  
  
  RESULTS
  A total of 625 eligible patients (458 males) were evaluated. During the 1-year follow-up period, 63 patients suffered recurrent vascular events. An elevated CRP level is an independent predictor of poor functional disability at 1 year (P for trend = .002), in both males (P for trend = .017) and females (P for trend = .042). Hcy showed no relationship with functional disability. No significant relationship between CRP and Hcy levels and recurrent vascular events was found in total patients in multiple models. Stratified by sex, high Hcy levels were associated with recurrent vascular events in females (P for trend = .036) but not in males.
  
  
  CONCLUSIONS
  Elevated CRP levels are associated with poor functional disability in patients with large-artery atherosclerotic stroke at 1 year, and Hcy is a relatively moderate predictor of recurrent vascular events in female patients with large-artery atherosclerotic stroke at 1 year.
authors.affiliation: Department of Neurology, Jinling Hospital, Southern Medical University, Nanjing, Jiangsu, China; Department of Neurology, The First Affiliated Hospital of Wenzhou Medical University, Wenzhou, Zhejiang, China.
authors.forename: Zusen
authors.initials: Z
authors.lastname: Ye
authors.affiliation: Department of Neurology, Jinling Hospital, Medical School of Nanjing University, Nanjing, Jiangsu, China.
authors.forename: Zhizhong
authors.initials: Z
authors.lastname: Zhang
authors.affiliation: Department of Neurology, Jinling Hospital, Medical School of Nanjing University, Nanjing, Jiangsu, China; Department of Neurology, The First People's Hospital of Hangzhou, Nanjing Medical University, Hangzhou, Zhejiang, China.
authors.forename: Hao
authors.initials: H
authors.lastname: Zhang
authors.affiliation: Department of Neurology, Jinling Hospital, Southern Medical University, Nanjing, Jiangsu, China.
authors.forename: Yonggang
authors.initials: Y
authors.lastname: Hao
authors.affiliation: Department of Neurology, Jinling Hospital, Medical School of Nanjing University, Nanjing, Jiangsu, China.
authors.forename: Jun
authors.initials: J
authors.lastname: Zhang
authors.affiliation: Department of Neurology, Jinling Hospital, Medical School of Nanjing University, Nanjing, Jiangsu, China.
authors.forename: Wenhua
authors.initials: W
authors.lastname: Liu
authors.affiliation: Department of Neurology, Jinling Hospital, Medical School of Nanjing University, Nanjing, Jiangsu, China.
authors.forename: Gelin
authors.initials: G
authors.lastname: Xu
authors.affiliation: Department of Neurology, Jinling Hospital, Southern Medical University, Nanjing, Jiangsu, China. Electronic address: xfliu2@vip.163.com.
authors.forename: Xinfeng
authors.initials: X
authors.lastname: Liu
mesh_terms: D000368:Aged; D050379:Arteriolosclerosis / Q000150:complications*; D002097:C-Reactive Protein / Q000378:metabolism*; D005260:Female; D006710:Homocysteine / Q000097:blood*; D006801:Humans; D008297:Male; D008875:Middle Aged; D011379:Prognosis; D011446:Prospective Studies; D012044:Regression Analysis; D012189:Retrospective Studies; D018709:Statistics, Nonparametric; D020521:Stroke / Q000097:blood* / Q000175:diagnosis / Q000209:etiology* / Q000401:mortality
chemical_list: D006710:Homocysteine; D002097:C-Reactive Protein
keywords: C-reactive protein; homocysteine; large-artery atherosclerotic stroke; prognosis