AUTHOR=Chen Liuting , Wang Min , Yang Chanrui , Wang Yefei , Hou Bonan 

TITLE=The role of high-sensitivity C-reactive protein serum levels in the prognosis for patients with stroke: a meta-analysis

JOURNAL=Frontiers in Neurology

VOLUME=14

YEAR=2023

URL=https://www.frontiersin.org/journals/neurology/articles/10.3389/fneur.2023.1199814

DOI=10.3389/fneur.2023.1199814

ISSN=1664-2295

ABSTRACT=<sec><title>Background</title><p>The impact of high-sensitivity C-reactive protein (hs-CRP) as a biomarker of inflammation on the prognosis of stroke patients remains controversial, this study was conducted to evaluate the prognostic value of hs-CRP levels for patients with stroke.</p></sec><sec><title>Methods</title><p>PubMed, Web of Science, Embase, and Cochrane Library databases were searched from inception to October 28, 2022. Outcome measures were all-cause mortality, recurrent stroke, and poor prognosis. The relationship between the highest versus lowest levels of hs-CRP or per unit increment and outcomes as measured by risk ratio (RR) and corresponding 95% confidence intervals (CI).</p></sec><sec><title>Results</title><p>A total of 39 articles were eligible for meta-analysis. High hs-CRP levels at admission were associated with mortality among patients with acute ischemic stroke (AIS) [RR = 3.84, 95% CI (2.41 ~ 6.111); <italic>p</italic> &lt; 0.001], risk of recurrent stroke [RR = 1.88, 95%CI (1.41 ~ 2.52); <italic>p</italic> &lt; 0.001], and poor prognosis [RR = 1.77, 95% CI (1.59 ~ 1.97); <italic>p</italic> &lt; 0.001]. The risk ratios for the association of per unit increase in hs-CRP levels with mortality, risk of recurrent stroke, and poor prognosis were as follows, respectively: 1.42 [95% CI (1.19–1.69); <italic>p</italic> &lt; 0.001], 1.03 [95% CI (1.01–1.04); <italic>p</italic> = 0.003], and 1.27 [95% CI (1.10–1.47); <italic>p</italic> = 0.001]. For hemorrhagic stroke (HS), the risk ratios (RR) for the highest versus the lowest (reference) category of hsCRP or per unit increment to all-cause mortality were 4.36 [95% CI (1.38–13.73); <italic>p</italic> = 0.012] and 1.03 [95% CI (0.98–1.08); <italic>p</italic> = 0.238].</p></sec><sec><title>Conclusion</title><p>Hs-CRP levels are strongly associated with mortality, risk of stroke recurrence and poor prognosis in stroke patients. Therefore, hs-CRP levels may contribute to the prognosis prediction of these patients.</p></sec>