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Prognostic value of admission C-reactive protein in stroke patients undergoing IV thrombolysis

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Abstract

Objective

To test the hypothesis that pre-treatment Creactive protein (CRP) predicts outcome in stroke patients undergoing intravenous thrombolysis (IVT) treatment.

Methods

We analyzed the data of 111 consecutive patients with IVT within 6 hours of stroke onset for stroke involving the middle cerebral artery territory and admission CRP ≤ 6 mg/dl.

Results

CRP levels were consistently, yet non-significantly lower in patients with unfavourable outcome definitions. Median (range) CRP levels were 0.3 (0–5.9) mg/dl vs. 0.4 (0–5.7) mg/dl (p = 0.13) in patients dependent or dead after 3 months (modified Rankin Scale score > 2; n = 59) vs. independent patients (n = 52); 0.2 (0.1–1.5) mg/dl vs. 0.4 (0–5.9) mg/dl (p = 0.28) in patients dead after 3 months (n = 14) versus survivors (n = 97); and 0.2 (0.1–0.7) mg/dl vs. 0.4 (0–5.9) mg/dl (p = 0.09) in patients with significant neurological deterioration within 24 hours (increase in ≥ 4 points on National Institute of Health Stroke scale; n = 9) vs. patients without early deterioration (n = 102). Independent predictors of dependency/death after 3 months, identified by multivariate logistic regression analyses, were baseline NIHSS score (OR = 1.31, 95 % CI 1.16–1.48, p < 0.001), time from onset to treatment (OR = 1.01, 95 % CI 1.0–1.02, p = 0.024), and presence of diabetes (OR = 8.16, 95 % CI 1.18–56.5, p = 0.033).

Conclusion

Pre-treatment CRP clearly failed to predict outcome in stroke patients treated with IVT. Our findings contradict previously published work and highlight the need for further research on this topic.

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Authors and Affiliations

  1. Dept. of Neurology, Academic Teaching Hospital, Wagner-Jauregg, Wagner-Jauregg-Weg 15, 4020, Linz, Austria

    R. Topakian MD, H.-P. Haring & F. T. Aichner

  2. Dept. of Radiology, Academic Teaching Hospital, Wagner-Jauregg, Linz, Austria

    K. Nussbaumer

  3. Dept. of Medical Statistics, Informatics and Health Economics, Innsbruck Medical University, Innsbruck, Austria

    A. M. Strasak

Authors
  1. R. Topakian MD
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  2. A. M. Strasak
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  3. K. Nussbaumer
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  4. H.-P. Haring
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  5. F. T. Aichner
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Correspondence to R. Topakian MD.

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Topakian, R., Strasak, A.M., Nussbaumer, K. et al. Prognostic value of admission C-reactive protein in stroke patients undergoing IV thrombolysis. J Neurol 255, 1190–1196 (2008). https://doi.org/10.1007/s00415-008-0866-y

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  • DOI: https://doi.org/10.1007/s00415-008-0866-y

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