C-reactive protein and outcome after first-ever ischemic stroke.

Abstract

To the Editor: We have carefully read the study of Keith Muir and colleagues published in Stroke1 regarding the putative role of C-reactive protein (CRP) as outcome predictor after ischemic stroke and would like to add further observations to their data. Despite the theoretical importance of CRP in ischemic stroke, very little direct evidence exists to implicate CRP in stroke. In their study, Muir and colleagues had not only investigated the CRP role but also discussed the causative role of inflammation in acute ischemic stroke. They found an intriguing association between CRP levels within 72 hours of stroke and an increased risk of death with an excess of cardiovascular mortality. The authors suggest three possible explanations to support the CRP role as predictor of outcome. They state that (1) CRP concentration may reflect the degree of stroke severity correlating with the degree of inflammation directly consequent to cerebral infarction, (2) CRP concentration may indicate underlying unstable atherosclerotic lesions, and (3) CRP may be raised as a consequence of secondary complications of stroke at the time of sampling. …