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High-sensitivity C-reactive protein is a strong risk factor for death after acute ischemic stroke among Chinese
Yue Huang1, Jing Jing, Xing-Quan Zhao
1Department of Orthopedic Surgery - Campbell Clinic and Pathology, University of Tennessee Health Science Center (UTHSC), Memphis, TN 38163, USA.
Insights
Elevated high-sensitivity C-reactive protein (hs-CRP) is a significant predictor of mortality in Chinese patients following acute ischemic stroke (IS). This finding highlights hs-CRP as a crucial biomarker for assessing stroke prognosis.
Area of Science:
- Biomarkers in cardiovascular disease
- Stroke outcome prediction
- Inflammation and cardiovascular events
Background:
- Elevated C-reactive protein (CRP) is linked to ischemic stroke (IS) and coronary disease.
- High-sensitivity CRP (hs-CRP) indicates poorer prognosis post-IS.
- Limited large-scale data on hs-CRP in Chinese populations exists.
Purpose of the Study:
- To investigate the association between hs-CRP levels and outcomes in Chinese patients after acute IS.
- To determine if hs-CRP is an independent predictor of mortality in this cohort.
Main Methods:
- Study included 741 acute IS patients with baseline hs-CRP measured within 24 hours.
- Patients were prospectively followed for 3 months for clinical outcomes and death.
- Multivariable Cox regression analyzed the association between hs-CRP (categorized as >3 mg/L vs. ≤3 mg/L) and outcomes, adjusting for confounders.
Main Results:
- High hs-CRP (>3 mg/L) was associated with a significantly higher rate of all-cause death at 3 months (10.00% vs. 0.71%).
- High hs-CRP was an independent risk factor for all-cause death (HR, 6.48).
- Other independent risk factors included atrial fibrillation, no statin therapy, high homocysteine, elevated fasting glucose, NIHSS score, and history of coronary heart disease.
Conclusions:
- Elevated plasma hs-CRP independently predicts the risk of all-cause death within 3 months after acute IS in Chinese patients.
- hs-CRP serves as a valuable prognostic biomarker in this population.
- Further research may explore therapeutic strategies targeting inflammation post-stroke.
Background And Purpose:
Elevated plasma C-reactive protein (CRP) has been suggested as a risk factor for ischemic stroke (IS) and coronary ischemic disease. Evidence has shown that high-sensitivity CRP (hs-CRP) is related to a worsening prognosis after IS, but hs-CRP was rare in a large-sample study in a Chinese population. We investigated the associations between hs-CRP and outcome of Chinese patients after acute IS.
Methods:
Seven hundred and forty-one consecutive acute IS patients (74.9% male, mean age 60.9 years), with baseline characteristics and hs-CRP measured within 24 h after hospitalization, were admitted in this study. We also prospectively followed up for clinical outcome and death 3 months after disease onset. hs-CRP was divided into two categories: hs-CRP >3 mg/L and hs-CRP ≤3 mg/L. Survival analysis using multivariable Cox regression was performed to analyze the association between hs-CRP and stroke outcomes after adjusting for potential confounding factors.
Results:
Compared with low hs-CRP, patients with high hs-CRP (>3 mg/L) had a significantly higher rate of all-cause death (0.71% vs. 10.00%; P < 0.001) at 3 months after stroke onset. High hs-CRP was an independent risk factor for all-cause death (HR, 6.48; 95% CI, 1.41 to 29.8; P= 0.016), as well as history of atrial fibrillation (HR, 5.24; 95% CI, 1.83 to 15.0; P= 0.002), no statin therapy during hospitalization (HR, 4.56; 95% CI, 2.18 to 9.55; P < 0.001), high homocysteine (>15.1 mmol/L) (HR, 2.66; 95% CI, 1.26 to 5.60; P= 0.01); fasting glucose (>6.1 mmol/L) (HR, 9.14; 95% CI, 3.34 to 25.0; P < 0.001), NIHSS at admission (HR, 2.35; 95% CI, 1.35 to 4.09; P= 0.003) and history of coronary heart disease (CHD) (HR, 2.34; 95% CI, 1.06 to 5.17; P= 0.035). Kaplan-Meier survival curves showed a higher risk of death for patients with hs-CRP >3 mg/L (P= 0.016).
Conclusion:
Elevated plasma hs-CRP independently predicted risk of all-cause death within 3 months after acute IS in Chinese patients.
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