Background: A number of studies have explored the prognostic role of CRP in patients
with acute ischemic stroke, however, the results have been inconclusive. The aim of our study was
to investigate the impact of infection on the association between CRP and 3-month functional outcome
by performing a registry study and systematic review.
Methods: Patients admitted within 24 hours of acute ischemic stroke onset and had CRP measured
within 24 hours after admission were included. Patients admitted between June 2016 and December
2018 in Chengdu Stoke Registry were enrolled. The PubMed database was searched up to July
2019 to identify eligible studies. Poor outcome was defined as modified Rankin Scale scores at
3-month more than 3.
Results: Totally, 368 patients in the registry and 18 studies involving 15238 patients in the systematic
review were included. A statistically significant association between CRP values on admission
and 3-month poor outcome in patients without infection was found, both in our registry
(CRP per 1-mg/L increment, OR 1.04, 95% CI 1.01 to 1.07, p=0.008) and meta-analysis (CRP per
1-mg/dL increment, OR 1.66 [95% CI 1.37 to 2.01, p<0.001]). In patients with infection, CRP was
not associated with a 3-month poor outcome according to registry data (OR 1.00, 95% CI 0.99 to
1.01, p=0.663) and meta-analysis (OR 1.01, 95% CI 0.99 to 1.01, p=0.128).
Conclusion: High CRP value was independently associated with a 3-month poor outcome after
stroke in patients without infection. Further studies are required to examine the value of infection
on CRP measures and long-term functional outcomes.