C-Reactive Protein and T3: New Prognostic Factors in Acute Ischemic Stroke

J Stroke Cerebrovasc Dis. 2018 Oct;27(10):2731-2737. doi: 10.1016/j.jstrokecerebrovasdis.2018.05.047. Epub 2018 Jul 26.

Abstract

Background: Several studies have shown that high level of plasma C-reactive protein (CRP) is associated with stroke outcomes and future vascular events, and a decrease in serum triiodothyronine (T3) was reported to be associated with stroke severity and poor prognosis.

Objective: The goal of this study is to evaluate CRP and T3 as independent predictors of poor functional and cognitive outcomes in patients with acute ischemic stroke at hospital discharge.

Methods: This study evaluated 120 patients who were admitted to the Clinical Hospital of Neurology and Psychiatry Brasov, between July 2016 and January 2017. The patients were evaluated for clinical stroke severity (National Institutes of Health Stroke Scale) and serum CRP and total T3 were evaluated on admission. Functional outcome and cognitive outcome were evaluated at discharge.

Results: The severity of NIHHS scores were associated with higher CRP levels (β = .583, P = .000) and lower T3 concentration (β = -.185, P = .043). Poor cognitive prognosis was associated with CRP levels (β = .441, P = .000) but not with T3 concentrations (P = .142). Poor functional outcome was associated with higher CRP levels (β = .457, P = .000), but not with T3 concentrations (P = .100). Using CRP and T3 as prognostic factors resulted in a probability of 53.5% to predict a poor functional outcome and of 80.42% to predict a poor cognitive outcome in stroke patients at discharge.

Conclusions: The study showed that higher CRP and lower T3 levels were associated with stroke severity on admission. Functional outcome is likely secondary to stroke severity but functional outcome at discharge was associated with higher CRP levels and not with T3 concentration. Cognitive outcome was associated with higher CRP levels and not with T3 concentration.

Keywords: Ischemic stroke—plasma C-reactive protein—triiodothyronine.

MeSH terms

  • Aged
  • Aged, 80 and over
  • Biomarkers / blood
  • Brain Ischemia / blood*
  • Brain Ischemia / diagnosis
  • Brain Ischemia / physiopathology
  • Brain Ischemia / psychology
  • C-Reactive Protein / analysis*
  • Cognition
  • Disability Evaluation
  • Female
  • Humans
  • Male
  • Middle Aged
  • Patient Admission
  • Patient Discharge
  • Predictive Value of Tests
  • Recovery of Function
  • Romania
  • Severity of Illness Index
  • Stroke / blood*
  • Stroke / diagnosis
  • Stroke / physiopathology
  • Stroke / psychology
  • Treatment Outcome
  • Triiodothyronine / blood*

Substances

  • Biomarkers
  • Triiodothyronine
  • C-Reactive Protein