Association of CRP levels and clinical and radiological outcomes in patients with large-vessel occlusion stroke: A MR CLEAN Registry study.

IF 4.5 3区医学 Q1 CLINICAL NEUROLOGY

European Stroke Journal Pub Date : 2025-07-19 DOI:10.1177/23969873251357134

Yan Wang, Sven Pr Luijten, Daniel Bos, Inge A Mulder, Manon Kappelhof, Willeke F Westendorp, Bart J Emmer, Stefan D Roosendaal, Yvo Bwm Roos, Ido R van den Wijngaard, Robert J van Oostenbrugge, Diederik van de Beek, Jonathan M Coutinho

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引用次数: 0

Abstract

Introduction: Inflammation is important in the pathogenesis of acute ischemic stroke (AIS). The association between CRP and outcomes in patients with large vessel occlusion (LVO) stroke receiving endovascular therapy (EVT) has not been fully elucidated.

Patients and methods: We used data from the MR CLEAN Registry (2014-2017), including LVO-AIS patients with intracranial carotid atherosclerotic disease (ICAD), extracranial carotid atherosclerotic disease (ECAD) or atrial fibrillation (AF). The primary outcome was modified Rankin Scale (mRS) score at 90 days. Secondary outcomes included mRS ⩾3 at 90 days, all-cause mortality, successful recanalization, and symptomatic intracranial hemorrhages. CRP was analyzed both dichotomously (>3.0 vs ⩽3.0 mg/L) and continuously, using multivariable regression adjusted for potential confounders.

Results: Among 865 included patients (ICAD: 286; ECAD: 154; AF: 425), median CRP level was 3.4 mg/L (IQR: 2.0-6.1) and 446 patients had elevated CRP (>3.0 mg/L). AF patients had higher CRP than ICAD and ECAD patients (4.0-3.0-3.2 mg/L, p = 0.002). CRP >3.0 mg/L was not associated with mRS in the full cohort (acOR 0.983, 95% CI (0.767, 1.260)) or in any etiological subgroups (ICAD: acOR = 0.968, 95% CI (0.626, 1.496), ECAD: acOR = 1.114, 95% CI (0.617, 2.012), AF: acOR = 0.937, 95% CI (0.653, 1.344)). There was also no association between CRP and any of the other outcomes. When analyzed as a continuous variable, CRP was also not associated with any other outcomes.

Conclusions: We did not observe an association between CRP levels and clinical and radiological outcomes after LVO stroke.

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大血管闭塞性卒中患者CRP水平与临床和放射预后的关系：一项MR CLEAN Registry研究

炎症在急性缺血性脑卒中（AIS）的发病机制中起重要作用。CRP与接受血管内治疗（EVT）的大血管闭塞（LVO）卒中患者预后之间的关系尚未完全阐明。患者和方法：我们使用MR CLEAN Registry（2014-2017）的数据，包括合并颅内颈动脉粥样硬化性疾病（ICAD）、颅外颈动脉粥样硬化性疾病（ECAD）或心房颤动（AF）的LVO-AIS患者。主要终点是90天时的改良Rankin量表（mRS）评分。次要结果包括mRS在90天时大于或等于3，全因死亡率，成功再通，以及有症状的颅内出血。采用多变量回归对潜在混杂因素进行校正，对CRP进行二分类分析（>3.0 vs≤3.0 mg/L）和连续分析。结果：865例患者(ICAD: 286例；适应型:154;AF: 425)，中位CRP水平为3.4 mg/L (IQR: 2.0-6.1)， 446例患者CRP升高（>3.0 mg/L）。AF患者CRP水平高于ICAD和ECAD患者（4.0 ~ 3.0 ~ 3.2 mg/L, p = 0.002）。在全队列（acOR 0.983, 95% CI(0.767, 1.260)）或任何病因亚组(ICAD: acOR = 0.968, 95% CI (0.626, 1.496), ECAD: acOR = 1.114, 95% CI （0.617, 2.012), AF: acOR = 0.937, 95% CI(0.653, 1.344)）中，CRP 3.0 mg/L与mRS无关（acOR = 0.983, 95% CI(0.767, 1.260)）。c反应蛋白与其他任何结果之间也没有关联。当作为一个连续变量进行分析时，CRP也与任何其他结果无关。结论：我们没有观察到CRP水平与左心室卒中后临床和放射预后之间的关联。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

European Stroke Journal Multiple-

CiteScore

7.50

自引率

6.60%

发文量

102

期刊介绍： Launched in 2016 the European Stroke Journal (ESJ) is the official journal of the European Stroke Organisation (ESO), a professional non-profit organization with over 1,400 individual members, and affiliations to numerous related national and international societies. ESJ covers clinical stroke research from all fields, including clinical trials, epidemiology, primary and secondary prevention, diagnosis, acute and post-acute management, guidelines, translation of experimental findings into clinical practice, rehabilitation, organisation of stroke care, and societal impact. It is open to authors from all relevant medical and health professions. Article types include review articles, original research, protocols, guidelines, editorials and letters to the Editor. Through ESJ, authors and researchers have gained a new platform for the rapid and professional publication of peer reviewed scientific material of the highest standards; publication in ESJ is highly competitive. The journal and its editorial team has developed excellent cooperation with sister organisations such as the World Stroke Organisation and the International Journal of Stroke, and the American Heart Organization/American Stroke Association and the journal Stroke. ESJ is fully peer-reviewed and is a member of the Committee on Publication Ethics (COPE). Issues are published 4 times a year (March, June, September and December) and articles are published OnlineFirst prior to issue publication.