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Prognostic influence of increased C-reactive protein and fibrinogen levels in ischemic stroke
M Di Napoli1, F Papa, V Bocola
1Department of Neurology and Neurorehabilitation, Villa Pini d'Abruzzo Care Center, Chieti, Italy. mariodinapoli@katamail.com
Insights
High C-reactive protein (CRP) levels predict worse outcomes in ischemic stroke patients. This elevated risk is independent of fibrinogen levels, highlighting CRP as a key prognostic marker.
Area of Science:
- Neurology
- Biomarkers
- Clinical Medicine
Background:
- Prognostic significance of fibrinogen and C-reactive protein (CRP) in ischemic stroke is not well-defined.
- Understanding these markers aids in predicting patient outcomes.
Purpose of the Study:
- To investigate and compare the 1-year prognostic influences of fibrinogen and CRP levels on outcomes in ischemic stroke patients.
- To determine the independent prognostic value of CRP in relation to fibrinogen.
Main Methods:
- 128 patients with first-ever ischemic stroke were analyzed.
- Fibrinogen and CRP levels were measured within 24 hours post-stroke.
- Survival analysis (Kaplan-Meier) and logistic regression were used to assess outcomes.
Main Results:
- Higher fibrinogen levels correlated with increased probabilities of death or vascular events (P=0.0172).
- Higher CRP levels showed a stronger association with adverse outcomes (P=0.0004).
- Elevated CRP and stroke severity independently predicted poor 1-year outcomes.
Conclusions:
- Increased C-reactive protein levels are significantly associated with worse outcomes in ischemic stroke.
- The prognostic impact of elevated CRP is independent of fibrinogen levels.
Background And Purpose:
The prognostic influences of fibrinogen and C-reactive protein (CRP) levels and their relations in ischemic stroke have not been well described. The aim of this study was to investigate and compare the 1-year prognostic influences of fibrinogen and CRP levels on outcome in ischemic stroke.
Methods:
Fibrinogen and CRP were determined within 24 hours after stroke and related to 1-year outcome in 128 patients with first-ever ischemic stroke. The Kaplan-Meier technique was applied in survival analysis. Multiple logistic regression analysis was used to evaluate the associations between risk factors and outcome.
Results:
The probabilities of death or new vascular event were 21.1%, 27.9%, and 51.7% (P:=0.0172, chi(2) for trend), respectively, in patients stratified by tertiles of fibrinogen (<3.78, 3.78 to 6.17, and >6.17 g/L). The probabilities of a primary end point were 12.1%, 29.7%, and 54.8% (P:=0.0004), respectively, after stratification of patient data by tertiles of CRP level (<5, 5 to 33, and >33 mg/L). In multiple logistic regression analysis, higher CRP levels (odds ratio, 2.39; 95% CI, 1.28 to 4.49; P:=0.0066) and stroke severity on the Canadian Neurological Stroke Scale (odds ratio, 2.37; 95% CI, 1.01 to 5.58; P:=0.0472) were independently associated with death or new vascular event.
Conclusions:
Increased levels of CRP are associated with a worse outcome in patients with ischemic stroke. The increased risk associated with elevated CRP levels is independent of the prognostic influence of fibrinogen.
