Association Between Hs-CRP Levels And The Outcomes Of Patients With Small-artery Occlusion

Background High-sensitivity C-reactive protein(hs-CRP)is not only a marker of inflammation but also a prognostic factor for ischemic stroke.It is reported that baseline plasma hypersensitivity c-reactive protein level is an independent risk factor for adverse clinical outcomes of acute ischemic stroke.The objective of our study was to investigative the association between hs-CRP levels and outcomes of patients with small-artery occlusion(SAO).Methods This study based on a hospital-based registry of the Department of Neurorehabilitation of Tianjin Huan Hu Hospital,retrospectively collected patients' data between October 25,2012 and June 30,2015.There were 2818 cases of ischemic stroke diagnosed within 7 days of stroke onset;among these,981 were diagnosed with SAO(according to Trial of Org 10172 in Acute Stroke Treatment classification),180 patients had no hs-CRP data,and 83 patients were lost to follow-up.Finally,718 patients with SAO were analyzed in this study.Data integrity and accuracy are reliable.Finally,patients were classified into three groups according to hs-CRP levels: < 0.91 mg/L,0.91 to < 2.77 mg/L,and ? 2.77 mg/L,patients were classified into 2 subgroups according to age(younger subgroup,< 75 years;elder subgroup,? 75 years).The prognosis of patients after 3 months was assessed by m RS score.Age,gender,hypertension,diabetes,abnormal lipid metabolism,smoking,drinking,obesity,NIHSS score as confounding factors.Comparing the differences of risk factors between different age groups with good prognosis and poor prognosis as single factor screening.The positive results were included in the logistic multivariate regression analysis,to study the correlation between hs-CRP and m RS score in different age groups after correction of confounding factors,Furthermore,the relationship between the level of hypersensitive c-reactive protein and prognosis of patients with different age was further analyzed.All data were analyzed by SPSS 17.0.Results 718 patients with SAO,mean age was61.7 ± 11.3 years old,and the average hs-CRP level was 1.54 mg/L.Among them,628 patients had a better prognosis after 3 months,and the other 90 had poor prognosis.In baseline analysis:hs-CRP? 2.77 mg/L: patients' age,the glycosylated hemoglobin is higher,the high-density lipoprotein value is lower,the high blood pressure,the diabetes,the obesity proportion is high,the drinker proportion is low,has the statistical difference;There was a statistical difference between three groups of total cholesterol value.Single factor analysis:Overall patient: age,sex,diabetes,smoking,alcohol consumption,hs-CRP and NIHSS scores were statistically different between good prognosis and poor prognosis(P<0.001,P<0.028,P<0.041,P<0.008,P<0.010,P<0.003,P<0.001);Young groups: gender,smoking,drinking,hs-CRP,NIHSS scores were statistically significant between the prognosis and poor prognosis(P<0.045,P<0.043,P<0.034,P<0.024,P<0.001);Age group: gender,obesity,NIHSS scores were statistically different between good prognosis and poor prognosis(P<0.032,P<0.046,P<0.036).The above factors were included in the Logistic regression analysis of each group.After correction overall the risk of poor prognosis in the highest level of hs-CRP(?2.77mg/l)was about 1.9 times the lowest level of hs-CRP(<0.91mg/l),the results were statistically significant(OR,1.917;95% CI,1.050–3.500;P = 0.034);Young group: the risk of poor prognosis of hs-CRP(?2.77mg/l)was about 2.1 times of the hs-CRP lowest layer(<0.91mg/l),the results were statistically significant(OR,2.092;95% CI,1.079–4.058;P = 0.029).Age group,There was no statistically significant difference between the three groups.Conclusion This study concluded that the increase of hs-CRP was an independent risk factor for poor prognosis in patients with SAO patients.But the index is only predictive for younger people(< 75 years old),and there is no predictive effect in older people(?75 years old).After the confounding factors were corrected,the conclusion was still valid.At present,The mechanism of hs-CRP and SAO outcome is not clear.More research is needed to prove the conclusion that more effective interventions are needed to reduce the burden on the SAO patients.