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C-reactive protein (CRP) in cerebro-vascular events
C R Canova1, C Courtin, W H Reinhart
1Internal Medicine, Kantonsspital, CH-7000, Chur, Switzerland.
Insights
C-reactive protein (CRP) levels do not predict outcomes for acute cerebrovascular events. This study found no significant differences in CRP values across various stroke types, unlike its established role in coronary heart disease prognosis.
Area of Science:
- Neurology
- Cardiology
- Biomarkers
Background:
- C-reactive protein (CRP) is a known prognostic marker in coronary heart disease.
- The utility of CRP in acute cerebrovascular events has not been previously investigated.
Purpose of the Study:
- To investigate the prognostic value of C-reactive protein (CRP) in patients experiencing acute cerebrovascular events.
- To determine if CRP levels can predict outcomes in different types of cerebrovascular incidents.
Main Methods:
- Prospective investigation of 138 patients admitted for acute cerebrovascular events.
- C-reactive protein (CRP) levels measured nephelometrically, with infection/inflammation excluded.
- Brain imaging (CT/MRI) and clinical course used for patient stratification into five groups.
Main Results:
- Median CRP values showed no significant differences among the five patient groups (transient ischemic attack, reversible neurological deficit, completed stroke with restitution, stroke without restitution, cerebral hemorrhage).
- Vascular risk factors did not influence CRP levels.
- No correlation found between symptom onset time and CRP levels, indicating minimal impact of acute cerebrovascular events on CRP.
Conclusions:
- C-reactive protein (CRP) is not a useful marker for predicting the outcome of acute cerebrovascular events upon hospital admission.
- This finding contrasts with the established prognostic role of CRP in acute coronary events.
Background And Purpose:
C-reactive protein (CRP) is a useful prognostic factor in coronary heart disease. It has not been previously studied in acute cerebro-vascular events, which was the topic of the present study.
Methods:
Patients admitted to the hospital for an acute cerebro-vascular event were prospectively investigated. C-reactive protein was determined nephelometrically. Infection or inflammation were excluded clinically and with an erythrocyte sedimentation rate <30 mm/h. Computed tomography or nuclear magnetic resonance imaging of the brain was performed.
Results:
According to initial brain imaging and the clinical course the 138 patients were divided into five groups: 20 with transient ischemic attack, 20 with reversible neurological deficit lasting less than 2 weeks, 61 with completed stroke and restitution, 16 with stroke without restitution and 21 with cerebral hemorrhage. Median CRP values (range) were 3.2 (2.4-13.5), 3.3 (2.4-39.4), 4.2 (2.4-73. 4), 3.4 (3.2-44.0) and 3.5 (2.4-104.0 mg/l), respectively with no significant differences between groups in a non-parametric test (Kruskal-Wallis). Risk factors for vascular disease in general and stroke in particular had no visible influence on CRP levels. No relationship was found between time interval since onset of symptoms and CRP measurement, suggesting that an acute cerebro-vascular event has little influence on CRP values.
Conclusion:
CRP is not a useful marker to predict the outcome of an acute cerebro-vascular event on hospital admission. This is in contrast to acute coronary events.