Serum levels of procalcitonin and high sensitivity C-reactive protein are associated with long-term mortality in acute ischemic stroke

• Published in: Journal of the neurological sciences 2015-05, Vol.352 (1), p.68-73
• Main Authors: Li, You-Mei, Liu, Xue-Yuan
• Format: Article
• Language: English
• Subjects: Acute ischemic stroke; Aged; Aged, 80 and over; Biomarkers - blood; Brain Ischemia - blood; Brain Ischemia - mortality; Brain Ischemia - physiopathology; C-Reactive Protein - analysis; Calcitonin - blood; Calcitonin Gene-Related Peptide; Chinese; Female; Follow-Up Studies; High sensitivity C-reactive protein; Humans; Male; Middle Aged; Mortality; Neurology; Predictive Value of Tests; Procalcitonin; Prognosis; Prospective Studies; Protein Precursors - blood; Severity of Illness Index; Stroke - blood; Stroke - mortality; Stroke - physiopathology; Time Factors
• ISSN: 0022-510X; 1878-5883
• DOI: 10.1016/j.jns.2015.03.032

Abstract Objective The aim of this study is to assess the prognostic value of systemic inflammation, as measured by the inflammatory biomarkers PCT and Hs-CRP, to predict the long-term mortality in ischemic stroke patients. Methods We prospectively studied 374 patients with ischemic stroke who were admitted within 24 h after the onset of symptoms. Serum levels of PCT, Hs-CRP and NIH stroke scale (NIHSS) were measured at the time of admission. Clinical follow-up was performed at 1 year. The prognostic value of PCT to predict the mortality within one year was compared with Hs-CRP, NIHSS and with other known outcome predictors. Results In the 64 non-survival patients, serum PCT levels were significantly ( P < 0.0001) higher compared with those in survival patients. Multivariate COX regression analysis showed that log-transformed PCT and Hs-CRP were independent mortality predictors with adjusted hazard ratio of 4.24 (95% confidence interval [CI], 2.42–6.30) and 15.37 (95% confidence interval [CI], 3.25–41.08). The area under the receiver operating characteristic curve of PCT and Hs-CRP were 0.89 (95% CI, 0.85–0.93) and 0.68 (95% CI, 0.59–0.77) for mortality, respectively. Conclusion Serum levels of PCT and HS-CRP at admission were independent predictor of long-term mortality after ischemic stroke in a Chinese sample.