A.E. Berezin, O.A. Lisovaya.Predictive value of high-sensitive C-reactive protein in patients with arterial hypertension after ischemic stroke

The aim – to evaluate the relationship between high-sensitive C-reactive protein (hs-CRP) plasma level and risk of recurrent coronary and cerebral ischemic events in arterial hypertension patients after ischemic stroke. Material and methods. 102 mild-to-moderate arterial hypertension patients were enrolled to the study 3 weeks after ischemic stroke and were studied prospectively during following 12 months. Serum high-sensitivity CRP level was determined only at study entry. Clinical interviews were performed every 3 months during 1 year after blood sampling. Clinical events included the following: certainly diagnosed ischemic stroke or transient ischemic attack; coronary ischemic events, sudden death, diabetes mellitus, and all cardiovascular events including chronic heart failure and hospitalizations. Results. Patients in the highest quartile of hs-CRP level had a significantly higher adjusted odds ratio for clinical events when compared to those in the first quartile (odds ratio = 7.46; 95 % CI = 1.55–19.6; P=0.001). A ROC curve detected a cutoff point of hs-CRP level of 5.58 mg/L (AUC=0.814±0.057; 95 % CI=0.702–0.925; 76.7 % sensitivity, 80.3 % specificity), which was used to include the variable into the multivariate model. After adjustment for age, sex, types of ischemic stroke, Barthel Index score and Rankin Scale at admission, a Cox regression model identified hs-CRP level higher than 5.58 mg/L an independent predictor of further cardiovascular events (HR=7.14; 95 % CI=1.15–12.6; P=0.009). Conclusions. We suggested that increasing of hs-CRP levels more than 5.58 mg/L strongly predicts the risk for cumulative clinical cardiovascular events in hypertensive patients after ischemic stroke.

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