This Article Full Text Full Text (PDF) All Versions of this Article: 36/4/e42    most recent 01.STR.0000158911.74006.d6v1 Alert me when this article is cited Alert me if a correction is posted Citation Map Services Email this article to a friend Similar articles in this journal Similar articles in PubMed Alert me to new issues of the journal Download to citation manager Request Permissions Citing Articles Citing Articles via HighWire Citing Articles via Google Scholar Google Scholar Articles by Genius, J. Articles by Lichy, C. Search for Related Content PubMed PubMed Citation Articles by Genius, J. Articles by Lichy, C. Related Collections Carotid and Vertebral A. Dissection Risk Factors for Stroke

(Stroke. 2005;36:e42.)
© 2005 American Heart Association, Inc.

Short Communications

Postacute C-Reactive Protein Levels Are Elevated in Cervical Artery Dissection

From the Department of Psychiatry (J.G., T.D.), Ludwig-Maximilian-Universität, Munich, Germany; Department of Neurology (A.G.), Städtisches Klinikum, Ludwigshafen, Germany; and Department of Neurology (J.G., C.L.), University of Heidelberg, Germany.

Correspondence to Dr Christoph Lichy, Department of Neurology, University of Heidelberg, INF 400 69120, Heidelberg, Germany. E-mail christoph_lichy{at}med.uni-heidelberg.de

Background and Purpose— C-reactive protein (CRP) is associated with atherogenesis and stroke in mostly elderly subjects. We tested whether elevated CRP may also be linked to spontaneous cervical artery dissection (CAD) and cryptogenic stroke.

Methods— We investigated high-sensitivity CRP levels in 62 patients <60 years of age experiencing cerebral ischemia resulting from large artery atherosclerosis (LAA; n=21), CAD (n=21), or cryptogenic etiology (n=20) >9 months ago, and in 54 sex- and age-matched population controls. Receiver operating characteristic curve was used to identify the best CRP cutoff level for dichotomization.

Results— CRP was elevated above control levels (0.54 [0.33 to 0.84] median, interquartile range mg/L) in patients with LAA (2.59 [0.56 to 3.99] mg/L; P<0.001) and with CAD (2.37 [0.57 to 4.78] mg/L; P=0.0013) but not in patients with cryptogenic etiology (0.74 [0.14 to 7.86] mg/L). CRP levels above the cutoff level of 0.71 mg/L were independently associated with former CAD (P=0.005) but not with former LAA after adjustment for age, gender, and conventional risk factors.

Conclusion— Our results strongly suggest that CRP is associated with CAD, independent from conventional risk factors, and that inflammatory mechanisms may play a role in its pathogenesis. This finding should be confirmed by larger studies.

Key Words: atherosclerosis • dissection • inflammation • stroke • young adults

This article has been cited by other articles:

				A. Pezzini, E. Del Zotto, G. Mazziotti, G. Ruggeri, F. Franco, A. Giossi, A. Giustina, and A. Padovani Thyroid Autoimmunity and Spontaneous Cervical Artery Dissection Stroke, September 1, 2006; 37(9): 2375 - 2377. [Abstract] [Full Text] [PDF]

				S. Prabhakaran, A. Khandji, and C. B. Wright Extracranial internal carotid artery dissection with unusual gadolinium enhancement Neurology, August 8, 2006; 67(3): 536 - 537. [Full Text] [PDF]

				M. Longoni, C. Grond-Ginsbach, A. J. Grau, J. Genius, S. Debette, M. Schwaninger, C. Ferrarese, and C. Lichy The ICAM-1 E469K gene polymorphism is a risk factor for spontaneous cervical artery dissection Neurology, April 25, 2006; 66(8): 1273 - 1275. [Abstract] [Full Text] [PDF]