(Stroke. 2001;32:133.)
© 2001 American Heart Association, Inc.
Original Contributions |
Prognostic Influence of Increased C-Reactive Protein and Fibrinogen Levels in Ischemic Stroke
From the Department of Neurology and Neurorehabilitation, Villa Pini d’Abruzzo Care Center, Chieti, Italy.
Correspondence to Dr Mario Di Napoli, MD, Department of Neurology and Neurorehabilitation, Casa di Cura Villa Pini d’Abruzzo, Via dei Frentani 228, 66100 Chieti, Italy. E-mail mariodinapoli{at}katamail.com
Background and Purpose—The prognostic influences of fibrinogen and C-reactive protein (CRP) levels and their relations in ischemic stroke have not been well described. The aim of this study was to investigate and compare the 1-year prognostic influences of fibrinogen and CRP levels on outcome in ischemic stroke.
Methods—Fibrinogen and CRP were determined within 24 hours after stroke and related to 1-year outcome in 128 patients with first-ever ischemic stroke. The Kaplan-Meier technique was applied in survival analysis. Multiple logistic regression analysis was used to evaluate the associations between risk factors and outcome.
Results—The
probabilities of death or new vascular event were 21.1%, 27.9%, and
51.7% (P=0.0172,
2 for trend), respectively, in patients
stratified by tertiles of fibrinogen (<3.78, 3.78 to 6.17, and >6.17
g/L). The probabilities of a primary end point were 12.1%, 29.7%, and
54.8% (P=0.0004),
respectively, after stratification of patient data by tertiles of CRP
level (<5, 5 to 33, and >33 mg/L). In multiple logistic regression
analysis, higher CRP levels (odds ratio, 2.39; 95% CI, 1.28 to
4.49; P=0.0066) and stroke
severity on the Canadian Neurological Stroke Scale (odds ratio, 2.37;
95% CI, 1.01 to 5.58;
P=0.0472) were independently
associated with death or new vascular
event.
Conclusions—Increased levels of CRP are associated with a worse outcome in patients with ischemic stroke. The increased risk associated with elevated CRP levels is independent of the prognostic influence of fibrinogen.
Key Words: C-reactive protein • fibrinogen • prognosis • risk factors • stroke, ischemic
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