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Hs-CRP in stroke: A meta-analysis
Yongjing Zhou1, Wei Han2, Dandan Gong1
1Institute of Molecular Biology & Translational Medicine, the Affiliated People's Hospital, Jiangsu University, Zhenjiang, Jiangsu 212002, PR China.
Insights
Elevated high-sensitivity C-reactive protein (hs-CRP) is linked to increased ischemic stroke risk. This meta-analysis found no clear association between hs-CRP and hemorrhagic stroke risk.
Area of Science:
- Cardiovascular Medicine
- Neuroscience
- Biomarkers
Background:
- Conflicting evidence exists regarding the association between high-sensitivity C-reactive protein (hs-CRP) and stroke risk.
- Understanding this relationship is crucial for stroke prevention strategies.
Purpose of the Study:
- To conduct a meta-analysis to determine if elevated baseline hs-CRP is an independent risk factor for different stroke subtypes.
- To provide a comprehensive assessment of hs-CRP's role in stroke etiology.
Main Methods:
- Systematic search of multiple databases (PubMed, Embase, Cochrane Library, CNKI, Wanfang) for prospective observational studies.
- Inclusion of studies reporting hs-CRP levels and adjusted risk estimates for stroke subtypes.
- Pooled analysis using fixed-effect model to calculate adjusted risk ratios (RRs) and 95% confidence intervals (CIs).
Main Results:
- Twelve studies with 66,560 participants and 2269 stroke events were analyzed.
- Elevated hs-CRP was associated with a significantly increased risk of ischemic stroke (RR 1.46, 95% CI 1.27-1.67).
- No significant association was found between hs-CRP and hemorrhagic stroke risk (RR 0.82, 95% CI 0.59-1.13).
Conclusions:
- Elevated baseline hs-CRP levels are an independent risk factor for ischemic stroke.
- Hs-CRP does not appear to be clearly associated with hemorrhagic stroke risk.
- Findings highlight the potential role of hs-CRP as a biomarker for ischemic stroke prediction.
Background:
Studies on high-sensitivity C-reactive protein (hs-CRP) and stroke risk have yielded conflicting results.
Objective:
To determine whether elevated baseline hs-CRP presents an independent risk for different kinds of strokes by conducting a meta-analysis.
Methods:
The PubMed, Embase, Cochrane Library, China National Knowledge Infrastructure and Wanfang databases were systematically searched for prospective observational studies published until January 2015. Studies reporting hs-CRP levels and adjusted risk estimates of different stroke subtypes by hs-CRP were selected. Pooled results were expressed as adjusted risk ratios (RRs), with corresponding 95% confidence intervals (CI) for the highest versus the lowest hs-CRP category.
Results:
Twelve studies involving 2269 strokes, of which 2436 were ischemic and 655 were hemorrhagic, were identified from 66,560 participants. When comparing the highest with the lowest hs-CRP category, the pooled RR of ischemic strokes was 1.46 (95% CI 1.27-1.67) in a fixed-effect model. The pooled RRs of all strokes and hemorrhagic stroke were 1.23 (95% CI: 0.997-1.51) and 0.82 (95% CI 0.59-1.13), respectively. The risk of ischemic strokes seemed higher in men (RR 1.66; 95% CI 1.23-2.24).
Conclusions:
Elevated baseline hs-CRP levels are independently associated with excessive ischemic stroke risk but exhibit no clear effect on hemorrhagic stroke.
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