High-sensitivity C-reactive protein and lipoprotein-associated phospholipase A2 in predicting recurrence and severity of stenosis in symptomatic intracranial atherosclerotic disease

2020 ◽  
Vol 17 ◽  
Author(s):  
Soumya Krishnamoorthy ◽  
Deepa Damayanthi ◽  
Srinivas Gopala ◽  
Rejith Paul ◽  
P. N. Sylaja

Background: Symptomatic intracranial atherosclerotic disease (sICAD) is associated with risk of recurrence of cerebral ischemic events in 4-19% of stroke patients annually. Previous studies indicate elevated high-sensitivity C-Reactive Protein (hs-CRP) and lipoprotein-associated phospholipase A2 (Lp-PLA2) to be associated with risk of recurrence. Objective: This prospective, observational study investigated serum levels of hs-CRP and the activity of Lp-PLA2 in patients with sICAD in predicting the risk of long-term stroke recurrence. Methods: We enrolled 48 patients with sICAD at 3 months from onset. The demographics, clinical and imaging characteristics were recorded. Serum hs-CRP and Lp-PLA2 activity were assessed using automated high-sensitivity C-reactive protein assay and photometric technique, respectively. Patients were followed up at 6 months and 1 year and presence of new vascular events were recorded. Results: The mean age of our study population was 59.5 ± 10.3 years and 91.7% were men. Four patients developed recurrent strokes during follow-up. The mean Hs-CRP was elevated in patients with events than in patients without events (5.9 ± 10.4 mg/L vs. 1.7 ± 2.4 mg/L, P=0.03). However, there was no significant association of mean Lp-PLA2 activity (118.3±42.9 nmol/min/ml vs. 111.9 ± 34.2 nmol/min/ml, P=0.73) with recurrence. Elevation of hs-CRP (3.02 ± 4.8 mg/L vs. 0.95 ± 0.57mg/L, P=0.02) and Lp-PLA2 activity (120.1±40.3 nmol/min/ml vs. 103.3 ± 23.9 nmol/min/ml, P=0.04) was correlated with high-grade stenosis in these patients. Conclusion: Our study suggests serum levels of hs-CRP may serve as a predictor of long-term stroke recurrence risk in sICAD and elevation of hs-CRP and Lp-PLA2 correlated with the severity of stenosis in symptomatic intracranial atherosclerotic disease.

2021 ◽  
pp. 71-73
Author(s):  
Amit Kumar Tiwari ◽  
Umesh Chandra Jha ◽  
Debarshi Jana

INTRODUCTION:Cerebrovascular accident (commonly called stroke) is dened as an abrupt onset of a neurologic decit that is attributable to a focal vascular cause. Thus, the diagnosis of stroke is clinical and laboratory studies including brain imaging are used to support the diagnosis AIMS AND OBJECTIVES: To evaluate the serum levels of high sensitivity C-reactive protein (hsCRP) in different types of cerebrovascular accidents on admission. MATERIALS AND METHODS: This study was an institution based cross-sectional study designed to investigate the association of hs-CRP levels with stroke and its types in Indian patients. The study was done in the Department of Medicine, Darbhanga Medical College and Hospital, Laheriasarai, Bihar from march 2019 to March 2020. 50 patients of either sex above 12 years of age admitted in Medicine Department of DMCH, Laheriasarai, Bihar with clinically or radiologically diagnosed stroke. RESULT: The mean level of hsCRP (mean ± s.d.) of the cases in our study was 7.65±7.01 with range 1.4 – 26 and the median was 3.7 and 58% of the cases were having level of hsCRP≥3 (p=0.023).Mean level of hsCRPof cases was signicantly higher than that of control (t98=7.25;p=0.001). CONCLUSION:We concluded that hs-CRPlevel is increased in cases of cerebrovascular accident- ischemic as well as haemorrhagic, suggesting an inammatory response in acute cerebrovascular accident. hs-CRP level is increased in patients with ischemic cerebrovascular accident dramatically but not in haemorrhagic cerebrovascular accident which might be considered as useful adjunct method for determining type of stroke in patients with cerebrovascular problems.


2014 ◽  
Vol 47 (4-5) ◽  
pp. 315-318 ◽  
Author(s):  
Ayo P. Doumatey ◽  
Jie Zhou ◽  
Adebowale Adeyemo ◽  
Charles Rotimi

2020 ◽  
Vol 41 (Supplement_2) ◽  
Author(s):  
Z Guo ◽  
L Lei ◽  
M Ying ◽  
B Wang ◽  
J Liu ◽  
...  

Abstract Background The use of high-sensitivity C-reactive protein (hs-CRP) as an inflammation biomarker in predicting long-term mortality remains controversial. We aimed to investigate whether the association of hs-CRP with long-term mortality differs from another inflammation biomarker, lipoprotein(a), in patients undergoing coronary angiography (CAG). Methods A total of 2422 patients undergoing CAG were included in the final analysis from a prospective, observational study. We divided them into 4 groups according to hs-CRP level (high ≥4.8 mg/l, low <4.8 mg/l) and lipoprotein(a) level (high ≥17 mg/dl, low <17 mg/dl). Results The overall incidence of all-cause long-term mortality was 133/2422 (5.5%). In the high lipoprotein(a) group, after adjusting for LDL-cholesterol concentration (LDL-C), age, sex, smoking status, diabetes mellitus and estimated glomerular filtration rate (eGFR), a high hs-CRP level was an independent predictor of all-cause long-term mortality (hazard ratio: 2.01; 95% CI: 1.13–3.54; p=0.02). In the low lipoprotein(a) group, a similar result was not found (hazard ratio: 1.42; 95% CI: 0.92–2.01; p=0.24). Conclusions Our data suggested that the association of hs-CRP with all-cause long-term mortality may differ from lipoprotein(a) levels among patients undergoing CAG. In addition to hs-CRP, a high lipoprotein(a) level might be a simultaneous intervention target for improving long-term prognosis in the future. Funding Acknowledgement Type of funding source: None


2015 ◽  
Vol 33 (3_suppl) ◽  
pp. 617-617 ◽  
Author(s):  
Andrea Casadei Gardini ◽  
Silvia Carloni ◽  
Emanuela Scarpi ◽  
Paolo Maltoni ◽  
Romolo Dorizzi ◽  
...  

617 Background: Serum levels of interleukine-6 and C-reactive protein are significatively higher in patients with neoplastic conditions. Therefore, the determination of high-sensitivity C-reactive protein (hs-PCR) has been widely used as a surrogate marker for chronic elevation of circulating cytokines. Increased hs-CRP concentrations have been reported in many conditions, in particular in patients with cardiovascular diseases, obesity, diabetes, autoimmunity, inflammatory bowel diseases and cancer risk. Some authors, on the basis of these findings, have encouraged further studies to clarify the etiologic and prognostic role of the aforementioned test. Our study has been conducted in patients enrolled in the phase III prospective multicentric randomized “Italian Trial in Advanced Colorectal Cancer (ITACa),” in order to assess hs-CRP levels at diagnosis and their significance with respect to overall survival (OS) and progresion free survival. Methods: Peripheral blood samples from 133 consecutive patients were collected into EDTA tubes. The collection was obtained before the beginning of first line chemotherapy. The supernatant was immediately transfer into a cryovial and stored at –80°C. Samples were thawed and hs-CRP has been measured with Cobas c501 analyzer. Results: Levels of hs-CRP >13.1 mg/L were associated with a worse median PFS, 8.9 months (95% CI 6.8-9.6) vs. 12.1 months (95% CI 9.3-14.9) in patients with levels <13.1 mg/L (p<0.0001). Similarly, levels >13.1 mg/L were associated with worse median OS, 14.4 (95% CI 11.5-17.1) vs. 28.8 (95% CI 24.3-36.6) in patients with a concentration <13.1 mg/L (p<0.0001). In multivariate analysis, hs-PCR adjusted for baseline factors including age (<70, ≥70 years), gender, ECOG perfomance status (0,1-2), tumor localization (rectum, colon), stage at diagnosis (I-III, IV), CT regimen (Folfiri, Folfox), KRAS status (wild type, mutant), site of metastases (liver, other metastases), was found to be independently associated with PFS and OS. Conclusions: Our study demonstrates the prognostic value of hs-CRP in patients with metastatic carcinoma of the colon and rectum.


2020 ◽  
Vol 9 (4) ◽  
pp. 1033
Author(s):  
Norihito Takahashi ◽  
Tomotaka Dohi ◽  
Hirohisa Endo ◽  
Takehiro Funamizu ◽  
Hideki Wada ◽  
...  

The aim of this study was to investigate the long-term clinical impact of residual inflammatory risk (RIR) by evaluating serial high-sensitivity C-reactive protein (hs-CRP) in Asian patients with coronary artery disease (CAD). We evaluated 2032 patients with stable CAD undergoing percutaneous coronary intervention (PCI) with serial hs-CRP measurements (2 measurements, 6–9 months apart) from the period 2000 to 2016. A high-RIR was defined as hs-CRP > 0.9 mg/L according to the median value. Patients were assigned to four groups: persistent-high-RIR, increased-RIR, attenuated-RIR, or persistent-low-RIR. Major adverse cardiac events (MACE) and all-cause death were evaluated. MACE rates in patients with persistent high, increased and attenuated RIR were significantly higher than in patients with persistent low RIR (p < 0.001). Moreover, the rate of all-cause death was significantly higher among patients with persistent high and increased RIR than among patients with attenuated and persistent low RIR (p < 0.001). After adjustment, the presence of persistent high RIR (hazard ratio (HR) 2.22; 95% confidence interval (CI) 1.37–3.67, p = 0.001), increased RIR (HR 2.25, 95%CI 1.09–4.37, p = 0.029), and attenuated RIR (HR 1.94, 95%CI 1.14–3.32, p = 0.015) were predictive for MACE. In addition, presence of persistent high RIR (HR 2.07, 95%CI 1.41–3.08, p < 0.001) and increased RIR (HR 1.94, 95%CI 1.07–3.36, p = 0.029) were predictive for all-cause death. A high RIR was significantly associated with MACE and all-cause death among Japanese CAD patients. An evaluation of changes in inflammation may carry important prognostic information and may guide the therapeutic approach.


2008 ◽  
Vol 14 (7) ◽  
pp. 981-984 ◽  
Author(s):  
J Sellner ◽  
I Greeve ◽  
HP Mattle

The anti-inflammatory potential of 3-hydroxy-3-methylglutaryl coenzyme A reductase inhibitors, as reflected by modulation of C-reactive protein (CRP), might be beneficial in the treatment of patients with multiple sclerosis (MS). We evaluated serum levels of high-sensitivity (hs)-CRP in relapsing–remitting MS patients receiving interferon-β 1b and atorvastatin as add-on therapy. This study shows that interferon-β treatment is associated with increased serum levels of hs-CRP in MS patients ( P < 0.01). In contrast, when atorvastatin is added to interferon-β, hs-CRP serum levels decrease to the normal range ( P < 0.05), indicating an anti-inflammatory action of atorvastatin in MS. However, whether add-on treatment with atorvastatin modifies the course of MS remains to be investigated.


2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Haozhang Huang ◽  
Yaren Yu ◽  
Liling Chen ◽  
Shiqun Chen ◽  
Ronghui Tang ◽  
...  

Abstract Background High-sensitivity C-reactive protein (hs-CRP) plays an important role in hypoalbuminemia as a representative of inflammation, which is closely associated with poor prognosis among patients with coronary artery disease (CAD). The present study aimed to evaluate the independent and joint effects of high hs-CRP levels and hypoalbuminemia on long-term mortality among CAD patients. Methods A total of 1449 CAD patients were included from a prospective, multicenter, observational cohort study (REICIN, NCT01402232) of patients referred for coronary angiography (CAG). The primary endpoint was long-term all-cause death. Results During a median follow-up of 2.9 (2.0–3.0) years, a total of 107 (7.4%) patients died. The long-term mortality was higher among CAD patients with high hs-CRP levels (> 3 mg/L) than those with the low hs-CRP levels (≤ 3 mg/L; 10.7% versus 4.1%; hazard ratio [HR] 2.49; 95% confidence interval [CI] 1.48–4.17). Similarly, CAD patients with hypoalbuminemia had higher mortality than those without hypoalbuminemia (12.2% versus 4.9%; HR 1.93; 95% CI 1.20–3.08). When hs-CRP and albumin were combined, CAD patients with high hs-CRP levels (> 3 mg/L) and with hypoalbuminemia were at the highest risk of death compared with their reference group (hs-CRP ≤ 3 mg/L and albumin > 35 g/L; HR 3.79; 95% CI 1.91–7.52). Conclusions High hs-CRP levels and hypoalbuminemia were independently and jointly associated with long-term mortality among CAD patients. Patients with high hs-CRP levels and hypoalbuminemia had the highest risk of long-term mortality compared with other groups.


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