Predictive Value of Ultrasensitive C-Reactive Protein in Ischemic Cerebrovascular Accident and Its Relation to Atherosclerosis of Carotid Arteries

Czech version

Authors: I. Vlachová ¹; R. Herzig ¹; H. Vaverková ²; D. Novotný ³; V. Krčová⁴; A. Bártková ¹; B. Křupka ¹; D. Šaňák ¹; K. Urbánek ¹; M. Budíková⁵; E. Sovová⁶; P. Kaňovský ¹
Authors‘ workplace: Neurologická klinika LF UP a FN v Olomouci ¹; III. Interní klinika LF UP a FN v Olomouci ²; Oddělení klinické biochemie FN v Olomouci ⁴Hemato-onkologická klinika LF UP a FN v Olomouci ⁵Klinika nukleární medicíny LF UP v FN v Olomouc ⁶I. interní klinika LF UP a FN v Olomouci ³
Published in: Cesk Slov Neurol N 2007; 70/103(1): 49-55
Category: Original Paper

Vytvořeno za podpory grantu IGA MZ ČR NF7492-3/2003.

Overview

Introduction:
Atherosclerosis plays an essential role in the etiopathogenesis of ischemic cerebrovascular accident (iCVA). A chronic inflammatory process shares significantly in its development. Among the inflammation indices, ultrasensitive C-reactive protein (hsCRP) has been considered an independent risk factor of ictus, predictor of a more severe affection, relapses as well as other cardiovascular disorders. The research aimed at judging the effects of hsCRP on the severity of iCVA in the acute phase, the relation to the iCVA subtypes, atherosclerosis of carotid arteries, and its possible predictive value.

A set of patients and methods:
The plasma hsCRP levels were determined in 110 probands (66 men, 44 women, mean age 61.5 ± 9.9 years) in the acute phase of iCVA. The accident severity was evaluated according to NIHSS criteria. A set was divided, according to etiology, into three groups (atherothrombotic – AT, embolic arterio-arterial – EA, cardioembolic – EC ictuses) and according to the degree of atherosclerotic affection of carotid arteries (≤ 30 %, 30 – 69 %, ≥ 70 %). Three months after the acute phase of the disease hsCRP was examined in 78 probands (44 men, 34 women). A control set (CS) consisted of 58 healthy subjects (32 men, 26 women, mean age 57.1 ± 9.9 years).

Results:
If compared with CS, higher levels of hsCRP were revealed in: (1) probands in the acute phase (p < 0.0001), (2) patients with NIHS < 10 (p = 0.001) as well as NIHSS ≥ 10 (p < 0.0001), (3) subtype of AT ictus (p < 0.0001), less in EC (p = 0.01) and EA (p = 0.01), (4) degrees of carotid stenoses ≤ 30 % (p = 0.008), 30 – 69 % (p = 0.004) and ≥ 70 % (p = 0.001), (5) probands after three months (p < 0.0001). No difference was found with regard to the Glasgow Outcome Scale (GOS).

Conclusion:
The study has confirmed the connection of higher hsCRP levels in the acute phase of iCVA and severity of a neurological deficit as well as that of higher hsCRP levels and carotid artery atherosclerosis.

Key-words:
ischemic ictus, atherosclerosis, ultrasensitive CRP, carotid stenosis

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