Elevated CRP at admission predicts post-stroke cognitive impairment in Han Chinese patients with intracranial arterial stenosis

Abstract

Objectives:

Elevated C-reactive protein (CRP) levels have been associated with cognitive deficits in certain patient populations, but whether this is also true of ischemic stroke patients is controversial. This study aims to examine the possible association between CRP concentration and post-stroke cognitive impairment (PSCI) in Han Chinese patients and to determine whether this association depends on intracranial arterial stenosis (ICAS).

Methods:

Patients with mild or moderate stroke admitted to a large regional medical center in Western China were consecutively enrolled in our study. Serum levels of CRP and ICAS severity were assessed at admission and cognitive status was assessed 6 months after stroke using the Six-Item Screener.

Results:

Of the 1116 patients included in our study, no association was observed between CRP levels at admission and cognitive performance at 6 months. However, among the subgroup of 311 patients with ICAS, a significant association did exist, and it persisted even after adjusting for potential confounders (OR 1.038, 95% CI 1.015–1.061). We did not find the same association in the subgroup of the patients without ICAS.

Conclusions:

To our knowledge, this is the first study to explore the effects of CRP on PSCI in Han Chinese with ICAS. Our findings indicate that higher CRP levels at admission are associated with subsequent cognitive decline in Han Chinese patients with ICAS following ischemic stroke. Further studies in other ethnic groups are needed to validate the use of CRP to predict dementia in ICAS patients.

Keywords:

• C-reactive protein
• intracranial arterial stenosis
• ischemic stroke
• post-stroke cognitive impairment

Acknowledgments

The authors thank the patients who participated in this study.