C-reactive protein predicts further ischemic events in patients with transient ischemic attack or lacunar stroke

Mengozzi, Manuela, Kirkham, Frances A, Girdwood, Esme E R, Bunting, Eva, Drazich, Erin, Timeyin, Jean, Ghezzi, Pietro and Rajkumar, Chakravarthi (2020) C-reactive protein predicts further ischemic events in patients with transient ischemic attack or lacunar stroke. Frontiers in Immunology, 11. a1403 1-7. ISSN 1664-3224

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Patients who have experienced a first cerebral ischemic event are at increased risk of recurrent stroke. There is strong evidence that low-level inflammation as measured by high sensitivity C-reactive protein (hs-CRP) is a predictor of further ischemic events. Other mechanisms implicated in the pathogenesis of stroke may play a role in determining the risk of secondary events, including oxidative stress and the adaptive response to it and activation of neuroprotective pathways by hypoxia, for instance through induction of erythropoietin (EPO). This study investigated the association of the levels of CRP, peroxiredoxin 1 (PRDX1, an indicator of the physiological response to oxidative stress) and EPO (a neuroprotective factor produced in response to hypoxia) with the risk of a second ischemic event. Eighty patients with a diagnosis of lacunar stroke or transient ischemic attack (TIA) were included in the study and a blood sample was collected within 14 days from the initial event. Hs-CRP, PRDX1 and EPO were measured by ELISA. Further ischemic events were recorded with a mean follow-up of 42 months (min 24, max 64). Multivariate analysis showed that only CRP was an independent predictor of further events with an observed risk (OR) of 1.14 (P = 0.034, 95% CI 1.01-1.29). No association was observed with the levels of PRDX1 or EPO. A receiver operating curve (ROC) determined a cut-off CRP level of 3.25 μg/ml, with a 46% sensitivity and 81% specificity. Low-level inflammation as detected by hs-CRP is an independent predictor of recurrent cerebrovascular ischemic events.

Item Type: Article
Keywords: TIA, lacunar stroke, cerebral ischemia, inflammation, oxidative stress, CRP, peroxiredoxin 1, erythropoietin
Schools and Departments: Brighton and Sussex Medical School > Clinical and Experimental Medicine
SWORD Depositor: Mx Elements Account
Depositing User: Mx Elements Account
Date Deposited: 04 Jun 2020 10:45
Last Modified: 24 Jul 2020 11:45
URI: http://sro.sussex.ac.uk/id/eprint/91593

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