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C-Reactive Protein Predicts Further Ischemic Events in Patients With Transient Ischemic Attack or Lacunar Stroke

Patients who have experienced a first cerebral ischemic event are at increased risk of recurrent stroke. There is strong evidence that low-level inflammation as measured by high sensitivity C-reactive protein (hs-CRP) is a predictor of further ischemic events. Other mechanisms implicated in the path...

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Autores principales: Mengozzi, Manuela, Kirkham, Frances A., Girdwood, Esme E. R., Bunting, Eva, Drazich, Erin, Timeyin, Jean, Ghezzi, Pietro, Rajkumar, Chakravarthi
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Frontiers Media S.A. 2020
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7358589/
https://www.ncbi.nlm.nih.gov/pubmed/32733466
http://dx.doi.org/10.3389/fimmu.2020.01403
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author Mengozzi, Manuela
Kirkham, Frances A.
Girdwood, Esme E. R.
Bunting, Eva
Drazich, Erin
Timeyin, Jean
Ghezzi, Pietro
Rajkumar, Chakravarthi
author_facet Mengozzi, Manuela
Kirkham, Frances A.
Girdwood, Esme E. R.
Bunting, Eva
Drazich, Erin
Timeyin, Jean
Ghezzi, Pietro
Rajkumar, Chakravarthi
author_sort Mengozzi, Manuela
collection PubMed
description Patients who have experienced a first cerebral ischemic event are at increased risk of recurrent stroke. There is strong evidence that low-level inflammation as measured by high sensitivity C-reactive protein (hs-CRP) is a predictor of further ischemic events. Other mechanisms implicated in the pathogenesis of stroke may play a role in determining the risk of secondary events, including oxidative stress and the adaptive response to it and activation of neuroprotective pathways by hypoxia, for instance through induction of erythropoietin (EPO). This study investigated the association of the levels of CRP, peroxiredoxin 1 (PRDX1, an indicator of the physiological response to oxidative stress) and EPO (a neuroprotective factor produced in response to hypoxia) with the risk of a second ischemic event. Eighty patients with a diagnosis of lacunar stroke or transient ischemic attack (TIA) were included in the study and a blood sample was collected within 14 days from the initial event. Hs-CRP, PRDX1, and EPO were measured by ELISA. Further ischemic events were recorded with a mean follow-up of 42 months (min 24, max 64). Multivariate analysis showed that only CRP was an independent predictor of further events with an observed risk (OR) of 1.14 (P = 0.034, 95% CI 1.01–1.29). No association was observed with the levels of PRDX1 or EPO. A receiver operating curve (ROC) determined a cut-off CRP level of 3.25 μg/ml, with a 46% sensitivity and 81% specificity. Low-level inflammation as detected by hs-CRP is an independent predictor of recurrent cerebrovascular ischemic events.
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spelling pubmed-73585892020-07-29 C-Reactive Protein Predicts Further Ischemic Events in Patients With Transient Ischemic Attack or Lacunar Stroke Mengozzi, Manuela Kirkham, Frances A. Girdwood, Esme E. R. Bunting, Eva Drazich, Erin Timeyin, Jean Ghezzi, Pietro Rajkumar, Chakravarthi Front Immunol Immunology Patients who have experienced a first cerebral ischemic event are at increased risk of recurrent stroke. There is strong evidence that low-level inflammation as measured by high sensitivity C-reactive protein (hs-CRP) is a predictor of further ischemic events. Other mechanisms implicated in the pathogenesis of stroke may play a role in determining the risk of secondary events, including oxidative stress and the adaptive response to it and activation of neuroprotective pathways by hypoxia, for instance through induction of erythropoietin (EPO). This study investigated the association of the levels of CRP, peroxiredoxin 1 (PRDX1, an indicator of the physiological response to oxidative stress) and EPO (a neuroprotective factor produced in response to hypoxia) with the risk of a second ischemic event. Eighty patients with a diagnosis of lacunar stroke or transient ischemic attack (TIA) were included in the study and a blood sample was collected within 14 days from the initial event. Hs-CRP, PRDX1, and EPO were measured by ELISA. Further ischemic events were recorded with a mean follow-up of 42 months (min 24, max 64). Multivariate analysis showed that only CRP was an independent predictor of further events with an observed risk (OR) of 1.14 (P = 0.034, 95% CI 1.01–1.29). No association was observed with the levels of PRDX1 or EPO. A receiver operating curve (ROC) determined a cut-off CRP level of 3.25 μg/ml, with a 46% sensitivity and 81% specificity. Low-level inflammation as detected by hs-CRP is an independent predictor of recurrent cerebrovascular ischemic events. Frontiers Media S.A. 2020-07-07 /pmc/articles/PMC7358589/ /pubmed/32733466 http://dx.doi.org/10.3389/fimmu.2020.01403 Text en Copyright © 2020 Mengozzi, Kirkham, Girdwood, Bunting, Drazich, Timeyin, Ghezzi and Rajkumar. http://creativecommons.org/licenses/by/4.0/ This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) and the copyright owner(s) are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.
spellingShingle Immunology
Mengozzi, Manuela
Kirkham, Frances A.
Girdwood, Esme E. R.
Bunting, Eva
Drazich, Erin
Timeyin, Jean
Ghezzi, Pietro
Rajkumar, Chakravarthi
C-Reactive Protein Predicts Further Ischemic Events in Patients With Transient Ischemic Attack or Lacunar Stroke
title C-Reactive Protein Predicts Further Ischemic Events in Patients With Transient Ischemic Attack or Lacunar Stroke
title_full C-Reactive Protein Predicts Further Ischemic Events in Patients With Transient Ischemic Attack or Lacunar Stroke
title_fullStr C-Reactive Protein Predicts Further Ischemic Events in Patients With Transient Ischemic Attack or Lacunar Stroke
title_full_unstemmed C-Reactive Protein Predicts Further Ischemic Events in Patients With Transient Ischemic Attack or Lacunar Stroke
title_short C-Reactive Protein Predicts Further Ischemic Events in Patients With Transient Ischemic Attack or Lacunar Stroke
title_sort c-reactive protein predicts further ischemic events in patients with transient ischemic attack or lacunar stroke
topic Immunology
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7358589/
https://www.ncbi.nlm.nih.gov/pubmed/32733466
http://dx.doi.org/10.3389/fimmu.2020.01403
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