Analysis Of The Relationship Between Serum High-sensitivity C-reactive Protein Levels And Ischemic Stroke NEW-TOAST Subtypes

Objective In order to conduct the early clinical etiology credits and individualtherapy，we studied the relationship between serum high-sensitivity C-reactive protein（hsCRP）levels and different ischemic stroke NEW-TOAST（Trial of Org10172inAcute Stroke Treatment Toast）subtypes.Methods We sequentially recruited111patients as the case group who sufferedthe first onset of ischemic stroke and were admitted to hospital within72hours. All thepatients of the case group were classified into5different subtype groups according toNEW-TOAST standard: atllerothrombosis（AT），small artery disease（SAD），cardioembolism（CE），stroke of other demonstrated etiology（SOD），stroke ofundemomtrated etiology（SUD）.Meanwhile45patients with idiopathic facial palsy orbenign paroxysmal positional vertigo were chosen as control group. Serum hsCRPlevels of all patients were tested on the following morning after admission and werecompared between the case group and control group and among each subtype. Then thecorrelation between serum hsCRP levels and ischemic stroke was analyzed，so did othercerebrovascular disease risk factors.Results The serum hsCRP levels of the case group[（2.21±4.92）mg/L]were higherthan that of the control group[（0.63±0.49）mg/L]，the difference was obviouslysignificant（P<0.01）. Serum hsCRP levels of different subtype groups were separatelythat AT（3.90±6.40）mg/L，SAD（1.34±3.45）mg/L，CE （5.02±9.33）mg/L，SOD（0.93±2.07）mg/L，SUD（0.71±1.02）mg/L. The significant diffrences were foundamong the five different subtype groups and the control group（P<0.01）. Serum hsCRPlevels of CE patients were elevated the most obviously. The levels of AT group werethe second higher. The third one was SAD. The serum hsCRP levels of each two group among the case group were different（P<0.05）. According to the statistical results，wecould see the serum hsCRP levels were different between AT group and SAD group，aslo and SOD（P<0.05）.The significant difference was between AT and SUD groups（P<0.01）.But the levels of serum hsCRP were not different between AT and CE group（P>0.05）.Between SAD and CE groups this indicator levels were different，alsobetween SAD and SOD（P<0.05）. The levels of serum hsCRP were different betweenCE and SOD、SUD groups（P<0.05）.A logistic regression test found significantdifference between serum hsCRP level and ischemic stroke after adjustment age、gender、diabetes and some other confounding factors（OR=1.840，OR95%CI1.272~2.287，P=0.002）. It suggested that high serum hsCRP levels independentlycorrelated with ischemic stroke. The Spearman correlation analysis result showed thatserum hsCRP levels were correlated with systolic pressure（r=0.178，P=0.026）、triglyceride（r=0.013，P=0.048），total cholesterol（r=0.094，P=0.024）（P<0.05）.Conclusions1、The levels of serum hsCRP of patients with acute ischemic strokeelevated obviously. The high serum hsCRP levels independently correlated withischemic stroke after correcting confounding factors.2、The levels of serum hsCRP of each NEW-TOAST subtype were different. Theserum levels of CE group were highest，the second was AT，the third was SAD. But theserum levels of SOD and SUD groups did not elevate significantly.