Association Between High‐Sensitivity C‐Reactive Protein and Prognosis in Different Periods After Ischemic Stroke or Transient Ischemic Attack
Background The aim of this study was to investigate the association between hsCRP (high‐sensitivity C‐reactive protein) and prognosis over time after stroke onset. Methods and Results In this prespecified prospective substudy of the Third China National Stroke Registry, a total of 9438 patients with...
| Main Authors: | , , , , , |
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| Format: | Article |
| Language: | English |
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Wiley
2022-07-01
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| Series: | Journal of the American Heart Association: Cardiovascular and Cerebrovascular Disease |
| Subjects: | |
| Online Access: | https://www.ahajournals.org/doi/10.1161/JAHA.122.025464 |
| _version_ | 1811167067943993344 |
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| author | Yu Wang Jiejie Li Yuesong Pan Mengxing Wang Xia Meng Yongjun Wang |
| author_facet | Yu Wang Jiejie Li Yuesong Pan Mengxing Wang Xia Meng Yongjun Wang |
| author_sort | Yu Wang |
| collection | DOAJ |
| description | Background The aim of this study was to investigate the association between hsCRP (high‐sensitivity C‐reactive protein) and prognosis over time after stroke onset. Methods and Results In this prespecified prospective substudy of the Third China National Stroke Registry, a total of 9438 patients with acute ischemic stroke or transient ischemic attack and measured hsCRP were included. Patients were categorized into 3 groups according to the sampling time after index onset (<24 hours, 24–72 hours, 72 hours–8 days). The outcomes consisted of stroke recurrence and combined vascular events within 1 year, and dependence or death defined as modified Rankin Scale score of 3 to 6 at 1 year. The associations between hsCRP and outcomes in different groups were analyzed by using Cox proportional hazards and logistic regression models. The median levels of hsCRP within 24 hours, between 24 and 72 hours and between 72 hours and 8 days were 2.01, 1.72, and 1.72 mg/L, respectively (P < 0.05). Compared with the bottom quartile, patients in the top quartile measured within 72 hours were at increased risk of recurrent stroke (<24 hours: adjusted hazard ratio [HR], 1.57 [95% CI, 1.05–2.35], P = 0.03; 24–72 hours: adjusted HR, 1.60 [95% CI, 1.18–2.17], P = 0.003). Association was attenuated after further adjusting for the Org 10 172 test in the Treatment of Acute Stroke classification (<24 hours: adjusted HR, 1.51 [95% CI, 1.01–2.27]; P = 0.05; 24–72 hours: adjusted HR, 1.55 [95% CI, 1.14–2.10]; P = 0.01). The association only existed in patients with large‐artery atherosclerosis (adjusted HR, 1.68 [95% CI, 1.06–2.64]; P = 0.03). However, the association was not found in the hsCRP level measured between 72 hours and 8 days. Similar results were found for the outcome of combined vascular events. Additionally, hsCRP levels measured between 24 and 72 hours were associated with an increased risk of poor functional outcomes. Conclusions Elevated levels of hsCRP measured in the first 72 hours after ischemic stroke or transient ischemic attack but not 72 hours to 8 days, were associated with an increased risk of 1‐year stroke recurrence. |
| first_indexed | 2024-04-10T16:02:58Z |
| format | Article |
| id | doaj.art-c7706175a43943abaeac9659e1f25e68 |
| institution | Directory Open Access Journal |
| issn | 2047-9980 |
| language | English |
| last_indexed | 2024-04-10T16:02:58Z |
| publishDate | 2022-07-01 |
| publisher | Wiley |
| record_format | Article |
| series | Journal of the American Heart Association: Cardiovascular and Cerebrovascular Disease |
| spelling | doaj.art-c7706175a43943abaeac9659e1f25e682023-02-10T09:15:42ZengWileyJournal of the American Heart Association: Cardiovascular and Cerebrovascular Disease2047-99802022-07-01111310.1161/JAHA.122.025464Association Between High‐Sensitivity C‐Reactive Protein and Prognosis in Different Periods After Ischemic Stroke or Transient Ischemic AttackYu Wang0Jiejie Li1Yuesong Pan2Mengxing Wang3Xia Meng4Yongjun Wang5Department of Neurology Beijing Tiantan Hospital, Capital Medical University Beijing ChinaDepartment of Neurology Beijing Tiantan Hospital, Capital Medical University Beijing ChinaDepartment of Neurology Beijing Tiantan Hospital, Capital Medical University Beijing ChinaDepartment of Neurology Beijing Tiantan Hospital, Capital Medical University Beijing ChinaDepartment of Neurology Beijing Tiantan Hospital, Capital Medical University Beijing ChinaDepartment of Neurology Beijing Tiantan Hospital, Capital Medical University Beijing ChinaBackground The aim of this study was to investigate the association between hsCRP (high‐sensitivity C‐reactive protein) and prognosis over time after stroke onset. Methods and Results In this prespecified prospective substudy of the Third China National Stroke Registry, a total of 9438 patients with acute ischemic stroke or transient ischemic attack and measured hsCRP were included. Patients were categorized into 3 groups according to the sampling time after index onset (<24 hours, 24–72 hours, 72 hours–8 days). The outcomes consisted of stroke recurrence and combined vascular events within 1 year, and dependence or death defined as modified Rankin Scale score of 3 to 6 at 1 year. The associations between hsCRP and outcomes in different groups were analyzed by using Cox proportional hazards and logistic regression models. The median levels of hsCRP within 24 hours, between 24 and 72 hours and between 72 hours and 8 days were 2.01, 1.72, and 1.72 mg/L, respectively (P < 0.05). Compared with the bottom quartile, patients in the top quartile measured within 72 hours were at increased risk of recurrent stroke (<24 hours: adjusted hazard ratio [HR], 1.57 [95% CI, 1.05–2.35], P = 0.03; 24–72 hours: adjusted HR, 1.60 [95% CI, 1.18–2.17], P = 0.003). Association was attenuated after further adjusting for the Org 10 172 test in the Treatment of Acute Stroke classification (<24 hours: adjusted HR, 1.51 [95% CI, 1.01–2.27]; P = 0.05; 24–72 hours: adjusted HR, 1.55 [95% CI, 1.14–2.10]; P = 0.01). The association only existed in patients with large‐artery atherosclerosis (adjusted HR, 1.68 [95% CI, 1.06–2.64]; P = 0.03). However, the association was not found in the hsCRP level measured between 72 hours and 8 days. Similar results were found for the outcome of combined vascular events. Additionally, hsCRP levels measured between 24 and 72 hours were associated with an increased risk of poor functional outcomes. Conclusions Elevated levels of hsCRP measured in the first 72 hours after ischemic stroke or transient ischemic attack but not 72 hours to 8 days, were associated with an increased risk of 1‐year stroke recurrence.https://www.ahajournals.org/doi/10.1161/JAHA.122.025464high‐sensitivity C‐reactive proteininflammationischemic strokeTIA |
| spellingShingle | Yu Wang Jiejie Li Yuesong Pan Mengxing Wang Xia Meng Yongjun Wang Association Between High‐Sensitivity C‐Reactive Protein and Prognosis in Different Periods After Ischemic Stroke or Transient Ischemic Attack Journal of the American Heart Association: Cardiovascular and Cerebrovascular Disease high‐sensitivity C‐reactive protein inflammation ischemic stroke TIA |
| title | Association Between High‐Sensitivity C‐Reactive Protein and Prognosis in Different Periods After Ischemic Stroke or Transient Ischemic Attack |
| title_full | Association Between High‐Sensitivity C‐Reactive Protein and Prognosis in Different Periods After Ischemic Stroke or Transient Ischemic Attack |
| title_fullStr | Association Between High‐Sensitivity C‐Reactive Protein and Prognosis in Different Periods After Ischemic Stroke or Transient Ischemic Attack |
| title_full_unstemmed | Association Between High‐Sensitivity C‐Reactive Protein and Prognosis in Different Periods After Ischemic Stroke or Transient Ischemic Attack |
| title_short | Association Between High‐Sensitivity C‐Reactive Protein and Prognosis in Different Periods After Ischemic Stroke or Transient Ischemic Attack |
| title_sort | association between high sensitivity c reactive protein and prognosis in different periods after ischemic stroke or transient ischemic attack |
| topic | high‐sensitivity C‐reactive protein inflammation ischemic stroke TIA |
| url | https://www.ahajournals.org/doi/10.1161/JAHA.122.025464 |
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