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High-sensitivity C-reactive protein predicts mortality but not stroke: the Northern Manhattan Study

M S V Elkind1, J M Luna, Y P Moon

  • 1Department of Neurology, Columbia University College of Physicians and Surgeons, New York, NY 10032, USA. mse13@columbia.edu

Neurology
|October 21, 2009
PubMed

Insights

High-sensitivity C-reactive protein (hsCRP) did not predict ischemic stroke in a multiethnic cohort but was linked to increased risk of myocardial infarction and mortality. Serum amyloid A (SAA) showed no association with stroke risk.

Area of Science:

  • Cardiovascular epidemiology
  • Inflammatory markers
  • Stroke and vascular disease research

Background:

  • Inflammation markers are linked to myocardial infarction (MI) risk.
  • The association between inflammation markers and stroke risk is debated.
  • Prospective cohort studies are crucial for understanding disease prediction.

Purpose of the Study:

  • To investigate the predictive value of high-sensitivity C-reactive protein (hsCRP) and serum amyloid A (SAA) for stroke, vascular events, and mortality.
  • To assess the role of these inflammatory markers in a multiethnic population.
  • To clarify the controversial association between inflammation and stroke risk.

Main Methods:

  • Prospective cohort study of stroke-free adults (aged >=40 years) from the Northern Manhattan Study.
  • Measurement of hsCRP and SAA using nephelometry.
  • Cox proportional hazards models to determine hazard ratios (HR) and 95% confidence intervals (CI) for outcomes, adjusting for demographics and risk factors.

Main Results:

  • hsCRP >3 mg/L was not significantly associated with ischemic stroke risk after full adjustment (adjusted HR = 1.20, 95% CI 0.78-1.86).
  • Elevated hsCRP (>3 mg/L) was associated with increased risk of myocardial infarction (adjusted HR = 1.70, 95% CI 1.04-2.77) and all-cause mortality (adjusted HR = 1.55, 95% CI 1.23-1.96).
  • Serum amyloid A (SAA) showed no association with stroke risk in this cohort.

Conclusions:

  • In this multiethnic cohort, hsCRP is not a significant predictor of ischemic stroke but shows a modest association with myocardial infarction and mortality.
  • The predictive utility of hsCRP and SAA may be influenced by population-specific characteristics, including age and the presence of other risk factors.
  • Further research is needed to elucidate the role of inflammatory markers in diverse populations and their specific associations with cardiovascular outcomes.
Abstract

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