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High-sensitivity C-reactive protein - a biomarker in stroke subtypes
Nina Camilla Nordly Lauritzen1,2, Lotta Larsson1, Ulriche-Sophie Thiim Pedersen1
1Neurovascular Research Unit, Department of Neurology, Copenhagen University Hospital - Herlev-Gentofte, Copenhagen, Denmark.
Insights
High-sensitivity C-reactive protein (hs-CRP) levels were higher in cardioembolic stroke patients acutely and at follow-up. Hs-CRP may indicate stroke inflammation but requires more validation for clinical use in stroke classification.
Area of Science:
- Neurology
- Biomarkers
- Inflammation Research
Background:
- Elevated C-reactive protein (CRP) is linked to cardiovascular events and stroke risk factors.
- High-sensitivity CRP (hs-CRP) shows potential for stroke subtype classification, but requires further validation.
- The role of hs-CRP in the chronic phase of stroke is not well understood.
Purpose of the Study:
- To investigate hs-CRP level changes across different ischemic stroke subtypes.
- To assess hs-CRP levels from acute admission to a three-month follow-up.
- To explore the potential of hs-CRP as a biomarker for stroke inflammation and classification.
Main Methods:
- Prospective cohort study including patients with ischemic stroke.
- hs-CRP levels measured on admission and at three-month follow-up.
- Stroke subtypes classified using the Trial of Org 10,172 in Acute Stroke Treatment (TOAST) system.
Main Results:
- Acute phase hs-CRP levels were significantly higher in cardioembolic stroke (CE) compared to small vessel occlusion.
- At three-month follow-up, hs-CRP remained elevated in CE compared to strokes of undetermined etiology.
- Across all stroke subtypes, hs-CRP levels decreased from acute to follow-up, with no significant differences between subtypes.
Conclusions:
- hs-CRP levels differ between ischemic stroke subtypes, notably higher in CE cases during both acute and follow-up phases.
- hs-CRP may serve as a biomarker reflecting stroke-related inflammation.
- Further validation is needed to establish the clinical utility of hs-CRP in stroke subtype classification.
Objective:
Higher levels of C-reactive protein (CRP) are associated with cardiovascular events and risk factors for stroke. Studies suggest that high sensitivity-CRP (hs-CRP) could be applied for stroke subtype classification but needs further validation. The utility of hs-CRP in the chronic phase also remains unclear. This study aimed to assess alterations in hs-CRP levels according to stroke subtypes from admission until three months follow-up.
Method:
In this prospective cohort, patients fulfilling diagnostic criteria for ischemic stroke were included in the Copenhagen General Population Study stroke biobank during acute admission. Assessment of hs-CRP was performed on admission and at a three-month follow-up. The Trial of Org 10,172 in Acute Stroke Treatment classification system was applied. Risk factors, stroke severity, and symptom onset were retrieved from the Danish Stroke Registry and medical records.
Results:
The study included 378 patients, of whom 177 had a corresponding blood sample at follow-up. Acute phase hs-CRP levels were higher in cardioembolic stroke (CE) compared to small vessel occlusion (p = 0.004). At follow-up, hs-CRP levels remained higher in CE compared to undetermined etiology (p = 0.014). In all subtypes, hs-CRP levels decreased from the acute phase to follow-up (p < 0.001) without differences between subtypes.
Conclusion:
Hs-CRP levels differed between ischemic stroke subtypes, with higher levels in CE in the acute phase and at three months follow-up. Hs-CRP may be a candidate biomarker reflecting inflammation in stroke but needs further validation in subtype classification before clinical utility.
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