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Ischemic stroke functional outcomes are independently associated with C-reactive protein concentrations and cognitive
Adomas Bunevicius1, Henrikas Kazlauskas, Nijole Raskauskiene
1Behavioral Medicine Institute, Lithuanian University of Health Sciences, Vyduno al. 4, 00135, Palanga, Lithuania, a.bunevicius@yahoo.com.
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High C-reactive protein (CRP) and low triiodothyronine (T3) predict poor stroke outcomes. This study found CRP independently predicts worse functional outcomes, while low T3 predicts worse cognitive outcomes after ischemic stroke.
Area of Science:
- Neurology
- Endocrinology
- Biochemistry
Background:
- Elevated C-reactive protein (CRP) and decreased triiodothyronine (T3) are linked to poor stroke prognosis.
- The combined prognostic value of CRP and T3 in stroke is not well understood, despite their known interaction.
Purpose of the Study:
- To investigate the association between thyroid hormone and CRP levels and immediate outcomes in ischemic stroke patients.
- To determine if CRP and T3 concentrations independently predict functional and cognitive outcomes post-stroke.
Main Methods:
- Eighty-eight ischemic stroke patients were assessed on admission for stroke severity (Scandinavian Stroke Scale), thyroid hormones (TSH, free T4, free T3), and CRP.
- Functional (modified Rankin Scale) and cognitive (Mini-Mental State Examination) outcomes were evaluated at discharge.
Main Results:
- Higher CRP concentrations correlated with greater stroke severity.
- Univariate analysis showed lower free T3 and higher CRP were associated with poor functional and cognitive outcomes.
- After adjusting for stroke severity, higher CRP independently predicted worse functional outcomes (β=0.18, p=0.04), and lower free T3 predicted worse cognitive outcomes (β=0.23, p=0.03).
Conclusions:
- Stroke severity is associated with elevated CRP.
- CRP and free T3 are independent predictors of functional and cognitive outcomes, respectively, in acute ischemic stroke patients.
- T3 and CRP may serve as valuable biomarkers for assessing stroke patient prognosis.
Abstract:
Elevated concentrations of C-reactive protein (CRP) and decreased concentrations of triiodothyronine (T3) were shown to predict poor outcomes in patients with stroke. However, the prognostic value of CRP and T3 has not been studied simultaneously in relation to stroke functional and cognitive outcomes despite of close interaction between inflammatory markers and thyroid function. We evaluated the association of thyroid hormone and CRP concentrations with immediate outcomes after ischemic stroke. Eighty-eight ischemic stroke patients on admission to the stroke unit were evaluated for clinical stroke severity (Scandinavian stroke scale or SSS) and concentrations of thyroid-stimulating hormone, free thyroxin, free T3, and CRP. Functional outcome (modified Rankin scale) and cognitive outcome (Mini mental state examination) were evaluated at discharge. Greater ln CRP concentrations (r = -0.35, p = 0.001), but not thyroid hormone concentrations, correlated with score on the SSS. In univariate analyses lower free T3 concentrations and higher CRP concentrations were associated with poor functional and poor cognitive outcomes. After adjustment for clinical stroke severity, higher CRP concentrations (β = 0.18, p = 0.04) remained associated with worse functional outcome and lower free T3 concentrations with worse cognitive outcome (β = 0.23, p = 0.03). In sum, clinical stroke severity is associated with elevated CRP concentration. Higher CRP concentration is independently associated with worse functional outcomes and lower free T3 concentration with worse cognitive outcomes at discharge. T3 and CRP can be important biomarkers in patients with acute ischemic stroke.
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