C-reactive protein and outcome after ischemic stroke

KW Muir, CJ Weir, W Alwan, IB Squire, KR Lees

Research output: Contribution to journalArticlepeer-review


Background and Purpose-Elevated concentrations of the acute-phase reactant C-reactive protein (CRP) predict ischemic cardiac events in both hospital- and population-based studies and may signify a role for inflammation in the destabilization of cardiovascular disease. We examined the relationship between CRP and outcome after acute ischemic stroke.

Methods-This was a subgroup analysis from a prospective observational study based in a University Hospital Acute Stroke Unit serving a population of approximate to 260 000, Survival time and cause of death for up to 4 years after the index stroke were determined and related to CRP concentration within 72 hours of stroke and known prognostic variables by a Cox proportional hazards regression model.

Results-Ischemic stroke was diagnosed in 228 of 283 consecutive admissions. Median follow-up was 959 days, Geometric mean CRP concentration was 10.1 mg/L. Survival in those with CRP >10.1 mg/L was significantly worse than in those with CRP less than or equal to 10.1 mg/L (P=0.00009, log-rank test). Higher CRP concentration was an independent predictor of mortality (hazard ratio, 1.23 per additional natural log unit; 95% CI, 1.13 to 1.35; P=0.02), together with age and stroke severity on the National Institutes of Health Stroke Scale. Cardiovascular disease accounted for 76% of deaths in those with CRP >10.1 mg/L and 63% of deaths in those with CRP less than or equal to 10.1 mg/L.

Conclusions-CRP concentration is an independent predictor of survival after ischemic stroke. These findings are consistent with a role for inflammation in acute ischemic stroke, as well as with the hypothesis that elevated CRP may predict future cardiovascular mortality.

Original languageEnglish
Pages (from-to)981-985
Number of pages5
Issue number5
Publication statusPublished - May 1999


  • acute-phase reaction
  • cerebrovascular disorders
  • C-reactive protein
  • inflammation
  • prognosis
  • RISK
  • RATS
  • MEN

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