The Role of High-sensitivity C-reactive Protein Serum Levels in the Prognosis for Patients with Stroke: a Meta-analysis

Overview

Journal Front Neurol

Specialty Neurology

Date 2023 Jun 21

PMID 37342777

Authors

Liuting Chen

Min Wang

Chanrui Yang

Yefei Wang

Bonan Hou

Affiliations

Soon will be listed here.

Abstract

Background: The impact of high-sensitivity C-reactive protein (hs-CRP) as a biomarker of inflammation on the prognosis of stroke patients remains controversial, this study was conducted to evaluate the prognostic value of hs-CRP levels for patients with stroke.

Methods: PubMed, Web of Science, Embase, and Cochrane Library databases were searched from inception to October 28, 2022. Outcome measures were all-cause mortality, recurrent stroke, and poor prognosis. The relationship between the highest versus lowest levels of hs-CRP or per unit increment and outcomes as measured by risk ratio (RR) and corresponding 95% confidence intervals (CI).

Results: A total of 39 articles were eligible for meta-analysis. High hs-CRP levels at admission were associated with mortality among patients with acute ischemic stroke (AIS) [RR = 3.84, 95% CI (2.41 ~ 6.111); < 0.001], risk of recurrent stroke [RR = 1.88, 95%CI (1.41 ~ 2.52); < 0.001], and poor prognosis [RR = 1.77, 95% CI (1.59 ~ 1.97); < 0.001]. The risk ratios for the association of per unit increase in hs-CRP levels with mortality, risk of recurrent stroke, and poor prognosis were as follows, respectively: 1.42 [95% CI (1.19-1.69); < 0.001], 1.03 [95% CI (1.01-1.04); = 0.003], and 1.27 [95% CI (1.10-1.47); = 0.001]. For hemorrhagic stroke (HS), the risk ratios (RR) for the highest versus the lowest (reference) category of hsCRP or per unit increment to all-cause mortality were 4.36 [95% CI (1.38-13.73); = 0.012] and 1.03 [95% CI (0.98-1.08); = 0.238].

Conclusion: Hs-CRP levels are strongly associated with mortality, risk of stroke recurrence and poor prognosis in stroke patients. Therefore, hs-CRP levels may contribute to the prognosis prediction of these patients.

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