Predictive Role of hsCRP in Recurrent Stroke Differed According to Severity of Cerebrovascular Disease: Analysis from a Prospective Cohort Study
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Jiejie Li1,2, Yuesong Pan1,2, Mengxing Wang1,2
1Department of Neurology, Beijing Tiantan Hospital, Capital Medical University, Beijing 100070, China.
Insights
High-sensitivity C-reactive protein (hsCRP) predicts recurrent stroke risk in minor stroke or TIA patients. This association was not observed in non-minor stroke cases, particularly in large-artery atherosclerosis.
Area of Science:
- Neurology
- Cardiology
- Biomarkers
Background:
- Elevated high-sensitivity C-reactive protein (hsCRP) is linked to increased recurrent stroke risk.
- The differential predictive value of hsCRP based on cerebrovascular disease severity remains unclear.
Purpose of the Study:
- To investigate whether the predictive value of hsCRP for recurrent stroke varies with cerebrovascular disease severity.
- To analyze hsCRP's association with new stroke events in patients with minor versus non-minor stroke.
Main Methods:
- Utilized data from 10,765 patients in the Third China National Stroke Registry (CNSR-III) cohort.
- Measured hsCRP levels and classified patients into minor stroke/TIA or non-minor stroke groups.
- Employed Cox proportional hazards models to assess the association between hsCRP levels and new stroke within 1 year.
Main Results:
- Elevated hsCRP levels significantly predicted recurrent stroke in minor stroke or TIA patients (NIHSS ≤3 or ≤5).
- The association was more pronounced in the large-artery atherosclerosis subtype.
- No significant association between hsCRP and recurrent stroke was found in non-minor stroke patients.
Conclusions:
- hsCRP is a valuable predictor of recurrent stroke in patients with minor stroke or TIA.
- hsCRP's predictive utility for recurrent stroke is dependent on disease severity, being significant in milder cases but not in severe ones.
Abstract:
Elevated levels of high-sensitivity C-reactive protein (hsCRP) were associated with an increased risk of recurrent stroke. However, it is still unknown whether the predictive value of hsCRP differed according to the severity of cerebrovascular disease. We used the cohort of the prospective multicenter cohort study of the Third China National Stroke Registry (CNSR-III), in which 10,765 consecutive patients with acute ischemic stroke or transient ischemic attack (TIA) had hsCRP levels measured. Patients were classified into minor stroke, or TIA, and non-minor stroke. The primary outcome was a new stroke within 1 year. Cox proportional hazards models were used to assess the association of hsCRP and its outcome. Elevated levels of hsCRP were associated with an increased risk of recurrent stroke in minor stroke or TIA patients, irrespective of using a National Institutes of Health Stroke Scale (NIHSS) score of ≤3 (the highest quartile vs. the lowest quartile: adjusted hazard ratio, 1.48; 95% CI, 1.12-1.97; p = 0.007) or ≤5 (the highest quartile vs. the lowest quartile: adjusted hazard ratio, 1.45; 95% CI, 1.15-1.84; p = 0.002) to define minor stroke. Such association was more apparent in the large-artery atherosclerosis subtype. However, for the patients with non-minor stroke, the association of hsCRP with recurrent stroke disappeared.
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