Plasma Measurement Of Hs-CRP And Lp(a) Levels For The Early Diagnosis Of Ischemic Stroke New TOAST Subtypes

Objective To investigate predictive value of plasma Hs-CRP and Lp(a) for acute ischemic stroke sutypes.Methods Consecutive 82 patients presenting to Department of Neural Medical of AnhuiProvincial Hospital Affiliated to Anhui Medical University between February 2010 to October 2010 with acute ischemic stroke were approached for consent to participate in our stud acdoring to inclusion and exclusion criterias and control subjects(n=60) were selected from heathy people of Medical Center at the same time. General information and epidemiological datas were collected and the levels of plasma Hs-CRP and Lp(a) in 82 consecutive acute stroke patients(<24hour) and control subjects were detected using immunonephelo metry and immune turbidimetirc methods.Holter, ultrasonography, CMRI/DWI,CMRA/CTA/DSA, and other tests were done to identify an etiologic diagnosis according to new-TOAST classification and statistical analyse.Result The mean plasma Hs-CRP level of the CE group was significantly higher than that of the other 3 subtypes and control subjects ( p<0.001)and it was statistically significant independent predictor of cardioembolic stroke after adjusting for age, sex, individual conventional vascular risk factors( OR=1.84;95%CI: 1.18-2.85;P< 0.05). The optimal cut-off concentration,sensitivity, specificity ,positive predictive value and negative predictive value of plasma Hs-CRP levels to distinguish CE from other stroke subtypes were 3.48 mg/l, 89% , 83%,88.94% and 84.67% respectively;The mean plasma Lp(a) level of the AT group was significantly higher than that of the other 3 subtypes and control subjects ( p<0.001) and it was statistically significant independent predictor of atherothrombosis after adjusting for age, sex, individual conventional vascular risk factors(OR=1.02 95%CI:1.01-1.03,P< 0.05). The optimal cut-off concentration, sensitivity, and specificity of plasma Lp(a) levels to distinguish AT from other stroke subtypes were 183.5 mg/l, 86.7% , 85.0%, 88.70% and 82.71%,respectively.Conclousions Monitoring the lever of Hs-CRP and Lp(a)may be a feasible strategy to improve the diagnosis of acute ischemic stroke subtypes. Plasma Hs-CRP can be a surrogate marker for CE and Plasma LP(a)can be a surrogate marker for AT...