High-sensitivity C-reactive protein - a biomarker in stroke subtypes.

OBJECTIVE

Higher levels of C-reactive protein (CRP) are associated with cardiovascular events and risk factors for stroke. Studies suggest that high sensitivity-CRP (hs-CRP) could be applied for stroke subtype classification but needs further validation. The utility of hs-CRP in the chronic phase also remains unclear. This study aimed to assess alterations in hs-CRP levels according to stroke subtypes from admission until three months follow-up.

METHOD: In this prospective cohort, patients fulfilling diagnostic criteria for ischemic stroke were included in the Copenhagen General Population Study stroke biobank during acute admission. Assessment of hs-CRP was performed on admission and at a three-month follow-up. The Trial of Org 10,172 in Acute Stroke Treatment classification system was applied. Risk factors, stroke severity, and symptom onset were retrieved from the Danish Stroke Registry and medical records.

RESULTS

The study included 378 patients, of whom 177 had a corresponding blood sample at follow-up. Acute phase hs-CRP levels were higher in cardioembolic stroke (CE) compared to small vessel occlusion (p = 0.004). At follow-up, hs-CRP levels remained higher in CE compared to undetermined etiology (p = 0.014). In all subtypes, hs-CRP levels decreased from the acute phase to follow-up (p < 0.001) without differences between subtypes.

CONCLUSION

Hs-CRP levels differed between ischemic stroke subtypes, with higher levels in CE in the acute phase and at three months follow-up. Hs-CRP may be a candidate biomarker reflecting inflammation in stroke but needs further validation in subtype classification before clinical utility.