Is there a prognostic role for C-reactive protein in ischemic stroke?

Area of Science:

• Neurology
• Cardiovascular Medicine
• Biomarkers

Background:

• Inflammation plays a critical role in the pathophysiology of ischemic stroke.
• C-reactive protein (CRP) is a key inflammatory marker with potential prognostic value in cardiovascular and cerebrovascular diseases.

Purpose of the Study:

• To investigate the association between acute-phase C-reactive protein (CRP) levels and the risk of subsequent fatal and non-fatal ischemic events following an initial ischemic stroke.
• To identify predictors of recurrent vascular events in stroke patients.

Main Methods:

• Analysis of 462 consecutive patients who experienced an incident ischemic stroke.
• Patients were stratified into two groups based on CRP levels: <9 mg/l and ≥9 mg/l.
• Follow-up was conducted to record primary endpoints, defined as any new fatal or non-fatal vascular event.

Main Results:

• During a mean follow-up of 2.27 years, 132 patients experienced a primary endpoint.
• Patients with CRP levels ≥9 mg/l had a significantly higher incidence of primary endpoints.
• Independent predictors of fatal events included CRP levels ≥9 mg/l, lack of secondary prevention therapy, and age >70 years.

Conclusions:

• Elevated C-reactive protein (CRP) levels (≥9 mg/l) measured within 24 hours of an ischemic stroke are a significant predictor of increased risk for future ischemic events and mortality.
• These findings highlight the prognostic utility of early CRP measurement in managing stroke patients.