Elevated plasma high-sensitivity C-reactive protein at admission predicts the occurrence of post-stroke fatigue at 6months after ischaemic stroke.

Abstract

Post-stroke fatigue (PSF) is a common neuropsychiatric affective symptom occurring after stroke. Evidence indicates activated inflammatory pathways are involved in modulating the stroke and fatigue. High-sensitivity C-reactive protein (hs-CRP) is one of the most sensitive indicators of inflammation. Our aim was to estimate the association between plasma hs-CRP and PSF after acute ischaemic stroke. In all, 212 acute ischaemic stroke patients were consecutively recruited within the first 14days after stroke onset and followed up for 6months. Plasma hs-CRP levels were assayed by enzyme linked immunosorbent assay. Fatigue severity was assessed using the Fatigue Scale for Motor and Cognitive Functions. A score≥43 is defined as PSF. Sixty-eight stroke patients (32.1%) were diagnosed with PSF at 6months' follow-up. In the patients with PSF, plasma hs-CRP levels were significantly higher compared with those in non-PSF patients (t=-8.524, P≤0.001). In multivariate analyses, plasma levels of hs-CRP were independently associated with PSF at 6months (odds ratio 3.435, 95% confidence interval 2.222-5.309; P≤0.001) after adjusting other recorded variables. Based on the receiver operating characteristic curve, the optimal cut-off value of plasma hs-CRP levels as an indicator for the prediction of PSF was projected to be 0.52mg/dl, which yielded a sensitivity of 77.9% and a specificity of 74.3%, with the area under the curve 0.794 (95% confidence interval 0.725-0.864; P≤0.001). Elevated plasma hs-CRP levels at admission were associated with PSF 6months after stroke, suggesting that these alterations might predict the development of PSF in stroke patients.