Association Between Long-term Functional Outcome and Change in hs-CRP Level in Patients With Acute Ischemic Stroke.

Abstract

Elevated high-sensitivity C-reactive protein (hs-CRP) has been suggested as a risk factor for ischemic stroke. However, the predictive value of hs-CRP for long-term outcomes is poorly defined. Therefore, we conducted this study to evaluate whether change in hs-CRP level plays a role in the prognostic value of long-term functional disability. We studied 263 patients with acute ischemic stroke and 104 healthy controls (67.5±11.26 and 68.17±11.21 y, respectively). hs-CRP was measured on admission and on the seventh day of hospitalization. The patients were classified into 2 groups on the basis of difference in hs-CRP level from admission to the seventh day of hospitalization (group 1, hs-CRP on admission>the seventh hospital day; group 2, hs-CRP on admission<the seventh hospital day). The correlation between change in hs-CRP level and functional disability using the modified Rankin Scale score (mRS) at 1, 3, 6, and 12 months after stroke onset was analyzed. We observed significant differences between initial hs-CRP level in all patients (0.96±2.82 mg/dL) and healthy controls (0.34±0.71 mg/dL, P=0.029). Significant differences in mRS at the 4 different timepoints was not observed between 2 groups (P=0.453, 0.225, 0.229, and 0.396, respectively). The Spearman rank-order correlation coefficients showed that change in hs-CRP level increasingly differed over time and was statistically correlated with mRS (coefficient/P: at 1 mo, 0.139/0.024; at 3 mo, 0.149/0.015; at 6 mo, 0.147/<0.001; and at 12 mo, 0.134/0.03). However, the results were very low correlation coefficients, despite their statistical significance. This study did not clearly show an association between increase in hs-CRP level over time and long-term functional disability.