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Nonlinear Association Between the C-Reactive Protein-To-Albumin Ratio and Post-Stroke Epilepsy Risk
Xiao Wu1, Yingru Zhou2, Qi Yang2
1Department of Neurosurgery, Jiangxi Key Laboratory of Neurological Diseases, the First Affiliated Hospital, Jiangxi Medical College, Nanchang University, Nanchang, Jiangxi, China.
CNS Neuroscience & Therapeutics
|July 16, 2026
Summary
The C-reactive protein-to-albumin ratio (CAR) is a strong predictor of post-stroke epilepsy (PSE) risk after ischemic stroke (IS). Higher CAR levels significantly increase the likelihood of developing PSE, highlighting its role in risk stratification.
Area of Science:
- Neurology
- Biomarkers
- Inflammation Research
Background:
- The C-reactive protein-to-albumin ratio (CAR) integrates inflammation and nutritional status.
- The association between CAR and post-stroke epilepsy (PSE) risk following ischemic stroke (IS) requires thorough investigation.
Purpose of the Study:
- To evaluate the independent predictive value of admission CAR for the development of PSE in IS patients.
- To explore the relationship's nature, including nonlinearity and potential thresholds.
Main Methods:
- Analysis of a large cohort (21,459 patients) of IS survivors.
- Multivariable logistic regression and restricted cubic spline (RCS) analyses to assess CAR's association with PSE risk.
- Subgroup and sensitivity analyses to confirm the robustness of findings.
Main Results:
- Elevated admission CAR was independently associated with a significantly increased risk of PSE (adjusted OR = 1.88 per unit increase).
- A nonlinear, threshold-based relationship was observed, with a pronounced dose-response effect across CAR quartiles.
- The highest CAR quartile showed a substantially elevated PSE risk (adjusted OR = 34.42).
Conclusions:
- CAR is a potent, independent predictor of PSE in IS patients.
- The findings suggest CAR can enhance early risk stratification and guide personalized interventions for PSE prevention.
- Further prospective validation of CAR's role in PSE is warranted.