Title:Association of High-sensitivity C-reactive Protein with Patient Prognosis Following Mechanical Thrombectomy for Acute Ischemic Stroke
VOLUME: 17 ISSUE: 4
Author(s):Seonggon Kim, Ho J. Yi*, Dong H. Lee and Jae H. Sung
Affiliation:Department of Neurosurgery, St. Vincent’s Hospital, College of Medicine, The Catholic University of Korea, Seoul, Department of Neurosurgery, St. Vincent’s Hospital, College of Medicine, The Catholic University of Korea, Seoul, Department of Neurosurgery, St. Vincent’s Hospital, College of Medicine, The Catholic University of Korea, Seoul, Department of Neurosurgery, St. Vincent’s Hospital, College of Medicine, The Catholic University of Korea, Seoul
Keywords:C-reactive protein, cerebral hemorrhage, inflammation, ischemic stroke, prognosis, thrombectomy.
Abstract:
Objective: The aim of this investigation was to examine the association of hsCRP (highsensitivity
C-reactive protein) with outcomes and prognosis of patients who underwent mechanical
thrombectomy (MT) for large vessel occlusion (LVO) after acute ischemic stroke (AIS).
Methods: A total of 404 patients were enrolled, and outcomes included unfavorable clinical outcome
at three months (modified Rankin Scale, mRS scores 3-6), the occurrence of symptomatic
intracerebral hemorrhage (sICH) and hemorrhagic transformation (HT) of the infarct. Receiver
operating characteristic (ROC) curve analysis was performed to identify the cutoff value of hsCRP
to discriminate between favorable and unfavorable outcomes. The association of hsCRP with outcomes
was evaluated using a logistic regression model.
Results: The best cutoff value of hsCRP to distinguish between favorable and unfavorable outcomes
at three months was identified as 3.0 mg/L (area under the curve, [AUC] 0.641, 95% confidence
interval, [CI] 0.535-0.748; P = 0.014). In, multivariate analysis, patients with hsCRP ≥3
mg/L had more unfavorable outcome (odds ratio [OR] 1.72, 95% CI 1.42-2.02; P = 0.010), sICH
(OR 2.64, 95% CI 1.62-3.66; P = 0.004), and HT of infarct (OR 1.72, 95% CI 1.42-2.02; P =
0.008) compared to those with hsCRP <1 mg/L.
Conclusion: Our study demonstrates that patients with higher CRP levels had more unfavorable
outcome, and exhibited higher sICH, and HT of infarct than those with lower CRP levels. Elevated
hsCRP level, especially when higher than 3 mg/L, is an independent predictor for poor clinical
prognosis in patients with MT for LVO.
