Combination of high-sensitivity C-reactive protein and homocysteine predicts the short-term outcomes of Chinese patients with acute ischemic stroke

Tu, Wen‐Jun; Zhao, Shengjie; Liu, Tonggang; Yang, Degang; Chen, Hui

doi:10.1179/1743132813y.0000000228

Cited by 54 publications

(46 citation statements)

References 68 publications

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“…This hypothesis has been observed in several clinical studies, with the high levels of serum Hcy as independent predictors for END for stroke patients [11, 14]. However, a recent study suggested conflicting results, demonstrating no association between elevated Hcy levels and functional outcome among elderly patients with acute cerebral infarction [15].…”

Section: Discussionmentioning

confidence: 88%

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Assessment of Homocysteine as a Diagnostic and Early Prognostic Biomarker for Patients with Acute Lacunar Infarction

Fan

Yang

et al. 2017

Eur Neurol

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Background: Although increasing evidence has demonstrated that elevated homocysteine (Hcy) levels may be an important contributor for the development of cerebral infarction, rare studies focused on its diagnostic and early prognostic roles in acute lacunar infarction. Methods: A total of 197 patients with acute lacunar infarction and 192 to form the control group were prospectively recruited between January 2013 and February 2017. Early neurological deterioration was defined as an increase of ≥2 points in National Institutes of Health Stroke Scale or the decrease in Barthel index (BI) score at discharge. Results: Univariate and multivariate logistic regression analyses revealed that higher levels of fibrinogen and Hcy were independently clinical predictors associated with lacunar infarction. Receiver operating characteristic curves analysis demonstrated that the diagnosis value of Hcy was superior to fibrinogen, with the area under the curve of 0.881 and 0.688 respectively. Using the optimal cutoff value of 15.5 μmol/L of Hcy, a sensitivity of 65% and a specificity of 100% were achieved for predicting lacunar infarction. Hcy was only significantly related with BI reduction in the males (30.5 [15.5–65.5] vs. 18 [15–24], p = 0.034) in the univariate analysis but not in the females and the multivariate analysis. Conclusions: Serum Hcy may be an independent diagnostic and not an early prognostic biomarker for patients with acute lacunar infarction.

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Section: Discussionmentioning

confidence: 88%

“…The serum Hcy levels were found to be significantly higher in stroke patients than those of normal controls [11-13]. Also, the high levels of serum Hcy were independent predictors for early neurological deterioration (END) and death in multivariate analysis [14], with the prognostic accuracy of 0.83 and 0.82, respectively [11].…”

Section: Introductionmentioning

confidence: 99%

Assessment of Homocysteine as a Diagnostic and Early Prognostic Biomarker for Patients with Acute Lacunar Infarction

Fan

Yang

et al. 2017

Eur Neurol

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“…23 It has been reported that hs-CRP and homocysteine were independent predictors of short-term outcome and mortality after acute ischaemic stroke. 24 In contrast, others found that hs-CRP concentration could predict neither functional disability 3 months after stroke onset, 25 nor the severity of short-term functional disability. 26 We are planning a prospective study to determine the correlation between hs-CRP concentration and prognosis in patients with IEAO.…”

Section: Discussionmentioning

confidence: 99%

Role of high sensitivity C-reactive protein and other risk factors in intracranial and extracranial artery occlusion in patients with ischaemic stroke

et al. 2015

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Objective: A retrospective case-control study to identify stroke-associated risk factors and quantify serum C-reactive protein in patients with ischaemic stroke, with or without intracranial and/or extracranial artery occlusion (IEAO). Methods: Patients with ischaemic stroke and internal carotid artery occlusion (ICAO), middle cerebral artery occlusion (MCAO), ICAO þ MCAO, or no IEAO (control patients) were retrospectively recruited. Data regarding stroke-associated risk factors were retrieved from medical records. High sensitivity (hs)-CRP was quantified within 3 days of hospital admission. Results: Patients with ICAO (n ¼ 89), MCAO (n ¼ 74) and ICAO þ MCAO (n ¼ 29) had significantly higher serum hs-CRP concentrations, and were significantly more likely to have coronary heart disease, a history of stroke, and more than three stroke-associated risk factors than control patients (n ¼ 84). Conclusions: Coronary heart disease and a history of stroke are risk factors for ischaemic stroke with IEAO. Hs-CRP may be used as a marker for IEAO.

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“…Similarly, in untreated patients, SUA declined at 6 to 12 hours (P=0.298), 48 hours (P=0.010), and 90 days (P=0.030) after stroke onset [26]. When recorded on admission, different variables were associated with poor outcome in stroke patients, for example, HS-CRP [33], HCY [33], glucose [34], and NIHSS score [35]. In this study, we also found that the NIHSS score, FBG, and Hs-CRP remained significant outcome predictors.…”

Section: Discussionmentioning

confidence: 99%

U-Shaped Relationship Between Functional Outcome and Serum Uric Acid in Ischemic Stroke

Yang

Zhang

et al. 2018

Cell Physiol Biochem

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Background/Aims: We sought to assess a consecutive number of patients with first-ever acute ischemic stroke (AIS), the clinical relevance in regard to functional outcome of the serum uric acid (SUA) measured at admission. Methods: In 2 prospective centers for observational study, serum concentrations of SUA were measured on admission in the serum of 710 consecutive patients with AIS. SUA concentrations were determined by high-performance liquid chromatography. SUA, NIH stroke scale (NIHSS), and conventional risk factors were evaluated to determine their value to predict functional outcome within 3 months. Results: During the follow-up, an unfavorable functional outcome (defined as a mRS score > 2) was found in 219 (30.8%) patients. The unfavorable functional outcome distribution across the SUA quartiles ranged between 12.4% (third quartile) and 50.6% (first quartile). After adjusting for all other significant outcome predictors, SUA concentration remained an independent unfavorable outcome predictor with an adjusted OR of 0.996 (95% CI, 0.993-0.998; P< 0.001). Conclusions: The data show that the U-shaped nature of the exposure-risk relationship was more prominent when the data were assessed in deciles (based on the SUA values). This model predicted the lowest relative risk of unfavorable outcome in the 67th percentile (corresponding to 309 µmol/L). SUA was significantly associated with the risk of poor functional outcomes in Chinese patients with stroke.

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Combination of high-sensitivity C-reactive protein and homocysteine predicts the short-term outcomes of Chinese patients with acute ischemic stroke

Abstract: High-sensitivity C-reactive protein and HCY are independent predictors of short-term outcome and mortality after AIS. The combined model may provide additional general prognostic information.

Cited by 54 publications

References 68 publications

Assessment of Homocysteine as a Diagnostic and Early Prognostic Biomarker for Patients with Acute Lacunar Infarction

Assessment of Homocysteine as a Diagnostic and Early Prognostic Biomarker for Patients with Acute Lacunar Infarction

Role of high sensitivity C-reactive protein and other risk factors in intracranial and extracranial artery occlusion in patients with ischaemic stroke

U-Shaped Relationship Between Functional Outcome and Serum Uric Acid in Ischemic Stroke

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