Association Between High C-reactive Sensitivity Protein Level And Clinical Outcomes In Acute Stroke

Objective:To observe high sensitivity C-reactive protein and clinical features in patients with acute stroke;To determine factors that influence high sensitivity C-reactive protein in acute stroke; To explore the association between high sensitivity C-reactive protein and outcomes in acute stroke.Materials and methods:1.We prospectively registered consecutive cases of acute stroke at the neurology wards of the Sichuan Provincial People’s HospitalfromJanuary.01,2011to October.31,2011. Patientes with ischemic and hemorrhage stroke within24hours of symptom onset were included.2、The level of serum high sensitivity C-reactive protein on admission or the next morning were measured. Other relevant factors influencing level of high sensitivity C-reactive protein and stroke outcome were also collected,and outcomes including death or disability followed up during hospital and at the end of3and6month. The increase of high sensitivity C-reactive protein(defined as hs-CRP>3mg/L) was analyzed by using multivariate logistical regression to evaluate the influencing factors for high sensitivity C-reactive protein.The same statistic model was also used to determine the association between high sensitivity C-reactive protein and clinical outcomes by adjusting other possible confounding factors.Results:1、We prospectively registered the1056cases of stroke patients at the neurology wards of the Sichuan Provincial People’s Hospital from January.01,2011to October.31,2011.320cases of acute stroke within24h from onset were included which accounted for30.30%of the total registered cases,188cases were male (58.75%);132cases were female (41.25%); The age range of the cases was19-95years old (67.8±12.7); included cerebral hemorrhage cases85(26.56%),ischemic stroke cases235(73.44%)2、We included320cases with the standard in our research, the level of high sensitivity C-reactive protein was from0.15mg/L to40.56mg/L,median was6.35mg/L, quartile was2.7-13.0mg/L. The median of cerebral hemorrhage was7.65mg/L, quartile was4.0-15.0mg/L. The median of ischemic stroke was5.0mg/L, quartile was2.0-10.0mg/L3、Though multivariate Logistic regression analysis indicated:the cases cerebral hemorrhage (OR1.483,95%CI0.280-0.833); female (OR1.306,95%CI0.114-0.817); the history of coronary heart disease (OR2.343, 95%CI1.065-5.178)、the patients with inflammation (OR7.516,95%CI3.075-18.371)、high glucose (OR1.187,95%CI1.093-1.288)、high plasma fibrinogen (OR2.766,95%CI1.560-4.905)、high leukocyte (OR1.485,95%CI1.333-1.654) and high NIHSS score(OR1.802,95%CI1.187-3.976) owned the higher risks of high sensitivity C-reactive protein.4、When the concentration of high-sensitivity C-reactive protein for acute stroke patients after admission to hospital was more than3mg/L, it becomes an independent risk factor for death or disability at the end of3and6month.Compared to the lower concentration, which was less than3mg/L, the risk of death for these patients is increased by1.863,1.065,1.237,1.663and1.348respectively. Except high-sensitivity C-reactive protein, NIHSS score and the age of patients were both the important influencing factor for death or disability at the end of3and6month.5、Multi-factor analysis for the patients with ischemic stroke and cerebral hemorrhage showed that the higher concentration of high-sensitivity C-reactive protein of the patients with ischemic stroke and cerebral hemorrhage after admission to hospital, which was more than3mg/L, became an independent risk factor for death or disability at the end of3and6month. Meanwhile, glucose and leukocyte for these patients when admission are also the important influencing factor for death at3 rd and6th month.Conclusion:1、Our study indicated that there were more than1/4patients with high sensitivity C-reactive protein in acute stroke.2、 The independent predictive factors for high sensitivity C-reactive protein were gender、the history of coronary heart disease、glucose、 leukocyte、plasma fibrinogen and NIHSS at admission.3、The high sensitivity C-reactive protein on admission were the independent predictive for death during hospitalization in acute stroke.Meanwhile, the high sensitivity C-reactive protein on admission were the independent predictive for death/disability at the end of3and6month in acute stroke.