Objective:

This study aimed to evaluate the predictive value of high-sensitivity C-reactive protein (hs-CRP) levels in patients with ischemic stroke.

Background:

C-reactive protein (CRP) is a biomarker of inflammation that may indicate vascular disease development, including ischemic stroke. There is conflicting evidence on whether CRP can predict stroke outcomes, with most studies focusing on mortality or future vascular events. Since nearly half of stroke patients suffer moderate to severe functional impairments, predicting functional recovery using CRP may be relevant for guiding stroke therapies.

Design/Methods:

Databases such as PubMed, Web of Science, Embase, and the Cochrane Library were searched until October 28, 2022. The outcomes measured were all-cause mortality, recurrent stroke, and poor prognosis. Risk ratios (RR) and 95% confidence intervals (CI) were used to assess the relationship between hs-CRP levels and outcomes, with 39 publications included in the meta-analysis.

Results:

Patients with acute ischemic stroke (AIS) had higher risks of death (RR = 3.84, 95% CI = 2.41-6.11; p < 0.001), recurrent stroke (RR = 1.88, 95% CI = 1.41-2.52; p < 0.001), and poor prognosis (RR = 1.77, 95% CI = 1.59-1.97; p < 0.001). A per-unit increase in hs-CRP was associated with higher risks of death (RR = 1.42, 95% CI = 1.19-1.69; p < 0.001), recurrent stroke (RR = 1.03, 95% CI = 1.01-1.04; p = 0.003), and poor prognosis (RR = 1.27, 95% CI = 1.10-1.47; p = 0.001). In hemorrhagic stroke, the highest hs-CRP category was associated with higher mortality risk (RR = 4.36, 95% CI = 1.38-13.73; p = 0.012).

Conclusions:

Hs-CRP levels may be useful in predicting stroke outcomes, including mortality, recurrence, and prognosis.