Combination of high-sensitivity C-reactive protein and homocysteine predicts the short-term outcomes of Chinese patients with acute ischemic stroke

Abstract

Background: Ischemic stroke is one of the most common causes of death worldwide. Early and accurate prediction of outcome in acute ischemic stroke (AIS) is important and influences risk-optimized therapeutic strategies. We investigated the changes in high-sensitivity C-reactive protein (Hs-CRP) and homocysteine (HCY) levels, two of the risk factors, during the acute period of AIS and evaluated the relationship between these levels and short-term prognosis.

Methods: We prospectively studied 189 patients with AIS who were admitted within 24 hours after the onset of symptoms. Serum Hs-CRP, HCY levels, and National Institutes of Health Stroke Scale (NIHSS) were measured at the time of admission. Short-term functional outcome was measured by the modified Rankin scale (mRS), 90 days after admission.

Results: The median serum Hs-CRP and HCY levels were significantly higher in AIS patients as compared to normal controls (P < 0·0001, respectively). High-sensitivity C-reactive protein and HCY were independent prognostic markers of functional outcome and death (adjusted for age and the NIHSS) in patients with AIS. In receiver operating characteristic curve analysis, the prognostic accuracy of the combined model (HCY and Hs-CRP) was higher compared to all measured biomarkers individually and the NIHSS score.

Conclusion: High-sensitivity C-reactive protein and HCY are independent predictors of short-term outcome and mortality after AIS. The combined model may provide additional general prognostic information.

Keywords:

• High-sensitivity C-reactive protein
• Homocysteine
• Acute ischemic stroke
• Prognosis
• short-term

All authors have contributed significantly, and are in agreement with the content of the manuscript.

This study was supported by National Natural Science Foundation of China (81071605). We thank Peng-Kun Li, for statistical advice and assistance with the qualitative measures used in this study. We also express our gratitude to all the patients who participated in this study, and thereby made this work possible.