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Elevated high-sensitivity C-reactive protein levels predict poor outcomes among patients with acute cardioembolic
Shumin Wang1, Xuejing Song1, Yajing Wang2
1Graduate School of Tianjin Medical University, Tianjin, China.
Insights
High hs-CRP levels in acute cardioembolic stroke patients predict poor outcomes. Levels of 22.30 mg/L or higher strongly indicate worse prognosis at 3 months and 1 year.
Area of Science:
- Cardiology
- Neurology
- Biomarkers
Background:
- High-sensitivity C-reactive protein (hs-CRP) is a potential stroke prognostic factor.
- The association between hs-CRP and outcomes in cardioembolic stroke (CES) patients is not well-established.
Purpose of the Study:
- To investigate the relationship between acute-phase hs-CRP levels and patient outcomes in first-onset CES.
- To determine if elevated hs-CRP predicts poor outcomes in CES patients.
Main Methods:
- 478 patients with first-onset CES were analyzed.
- Baseline hs-CRP levels were measured within 24 hours and categorized into quartiles.
- Outcomes were assessed using the modified Rankin scale (mRS) and composite endpoints at 3-month and 1-year follow-ups.
- Multivariate logistic regression analyzed the association between hs-CRP and outcomes.
Main Results:
- A median hs-CRP level of 6.09 mg/L was observed.
- Hs-CRP levels ≥22.30 mg/L were significantly correlated with poor outcomes at 3 months (OR: 3.862) and 1 year (OR: 5.479).
- Secondary composite endpoints also showed a significant association with elevated hs-CRP levels.
Conclusions:
- Elevated hs-CRP is an independent predictor of poor outcomes in CES patients.
- The predictive value of hs-CRP for poor outcomes is particularly significant at levels ≥22.30 mg/L.
Background:
High-sensitivity C-reactive protein (hs-CRP) as a prognostic factor of stroke has been proposed and studied. However, the relationship between hs-CRP levels and outcomes among patients with cardioembolic stroke (CES) remains unclear. This study aimed to evaluate the association between hs-CRP levels in the acute phase of CES and poor patient outcomes.
Methods:
We recruited 478 patients with first-onset CES. Hs-CRP and other biochemical markers were measured within 24 h after admission. Hs-CRP levels were grouped into quartiles (<2.31, 2.31 to <6.09, 6.09 to <22.30, and ≥22.30 mg/L). Stroke severity was assessed using the modified Rankin scale (mRS), with mRS scores of 0 to 2 classified as a good outcome, and scores of 3 to 6 as a poor outcome. Composite endpoints included poor outcomes, vascular death, myocardial infarction (MI), and recurrent stroke (ischemic or hemorrhagic). At 3-month and 1-year follow-ups, we used multivariate logistic regression analysis to assess the relationship between baseline hs-CRP levels, mRS scores, and composite endpoints.
Results:
Among 478 patients with CES, the median hs-CRP level was 6.09 mg/L. Regarding the primary outcome, we found that hs-CRP levels ≥22.30 mg/L were positively correlated with poor outcomes at the 3-month and 1-year follow-ups [odds ratio (OR): 3.862, 95% confidence interval (CI): (1.675-8.904), P=0.002; and OR: 5.479, 95% CI: (1.692-17.744), P=0.005, respectively]. The secondary outcomes paralleled the results of the primary outcomes at the 3-month and 1-year follow-ups [OR: 3.381, 95% CI: (1.620-7.058), P=0.001; and OR: 3.181, 95% CI: (1.475-6.860), P=0.003, respectively].
Conclusions:
Elevated hs-CRP in patients with CES is an independent predictor of poor outcomes; however, this association is particularly evident when hs-CRP ≥22.30 mg/L.
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