- •PCT and Hs-CRP were associated with ischemic stroke severity.
- •Non-survivors had significantly increased PCT and Hs-CRP levels on admission.
- •Multivariate COX regression analysis showed that PCT and Hs-CRP were independent mortality predictors.
- •The prognostic accuracy of PCT was higher compared to Hs-CRP, NIHSS score and other markers.
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.
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.
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.
Serum levels of PCT and HS-CRP at admission were independent predictor of long-term mortality after ischemic stroke in a Chinese sample.
To read this article in full you will need to make a payment
Purchase one-time access:Academic & Personal: 24 hour online accessCorporate R&D Professionals: 24 hour online access
One-time access price info
- For academic or personal research use, select 'Academic and Personal'
- For corporate R&D use, select 'Corporate R&D Professionals'
Subscribe:Subscribe to Journal of the Neurological Sciences
Already a print subscriber? Claim online access
Already an online subscriber? Sign in
Register: Create an account
Institutional Access: Sign in to ScienceDirect
- The global stroke initiative.Lancet Neurol. 2004; 3: 391-393
- Impact of functional status at six months on long term survival in patients with ischaemic stroke: prospective cohort studies.BMJ. 2008; 336: 376-379
- Thioredoxin is a novel diagnostic and prognostic marker in patients with ischemic stroke.Free Radic Biol Med. 2015; 80: 129-135
- Combination of high-sensitivity C-reactive protein and homocysteine predicts the short-term outcomes of Chinese patients with acute ischemic stroke.Neurol Res. 2013; 35: 912-921
- Free Radic Res. Acute phase proteins and oxidised low-density lipoprotein in association with ischemic stroke subtype, severity and outcome.Free Radic Res. 2007; 41: 282-287
- The serum high-sensitive C reactive protein and homocysteine levels to evaluate the prognosis of acute ischemic stroke.Mediators Inflamm. 2007; 2007: 15929
- Physiology and genetics of procalcitonin.Physiol Res. 2000; 49: S57-S62
- Procalcitonin and C-reactive protein during the early posttraumatic systemic inflammatory response syndrome.Intensive Care Med. 1998; 24: 185-188
- Experience from a multicentre stroke register: a preliminary report.Bull World Health Organ. 1976; 54: 541-553
- Classification of subtype of acute ischemic stroke. Definitions for use in a multicenter clinical trial. TOAST. Trial of Org 10172 in Acute Stroke Treatment.Stroke. 1993; 24: 35-41
- Classification and natural history of clinically identifiable subtypes of cerebral infarction.Lancet. 1991; 337: 1521-1526
- Measurements of acute cerebral infarction: lesion size by computed tomography.Stroke. 1989; 20: 871-875
- ABC/2 for rapid clinical estimate of infarct, perfusion, and mismatch volumes.Neurology. 2009; 72: 2104-2110
- Serum procalcitonin and C-reactive protein levels as markers of bacterial infection: a systematic review and meta-analysis.Clin Infect Dis. 2004; 39: 206-217
- The role of procalcitonin in febrile neutropenic patients: review of the literature.Infection. 2008; 36: 396-407
- Procalcitonin and C-reactive protein levels at admission as predictors of duration of acute brain dysfunction in critically ill patients.Crit Care. 2011; 15: R78
- Plasma procalcitonin and the risk of cardiovascular events and death: a prospective population‐based study.J Intern Med. 2012; 272: 484-491
- Procalcitonin, copeptin and midregional pro-atrial natriuretic peptide as markers of ischemic stroke risk: the Northern Manhattan Study.Stroke. 2014; 45: A54-A54
- Association of fibrinogen, C-reactive protein, albumin, or leukocyte count with coronary heart disease: meta-analyses of prospective studies.JAMA. 1998; 279: 1477-1482
- High-sensitivity C-reactive protein is a strong risk factor for death after acute ischemic stroke among Chinese.CNS Neurosci Ther. 2012; 18: 261-266
- High-sensitivity C-reactive protein, lipoprotein-associated phospholipase A2, and outcome after ischemic stroke.Arch Intern Med. 2006; 166: 2073-2080
- Prognostic value of procalcitonin in community-acquired pneumonia.Eur Respir J. 2011; 37: 384-392
- Procalcitonin kinetics as a prognostic marker of ventilator-associated pneumonia.Am J Respir Crit Care Med. 2005; 171: 48-53
- Copeptin, procalcitonin and routine inflammatory markers—predictors of infection after stroke.PLoS One. 2012; 7: e48309
- Relationship of 6-month functional outcome and stroke severity: implications for acute stroke trials from the Northern Manhattan Stroke Study [abstract].Neurology. 1998; 50: A327
- Baseline NIH Stroke Scale score strongly predicts outcome after stroke: a report of the Trial of Org 10172 in Acute Stroke Treatment (TOAST).Neurology. 1999; 53: 126-131
- Procalcitonin and C-reactive protein during systemic inflammatory response syndrome, sepsis and organ dysfunction.Crit Care. 2004; 8: R234
- Treating patients with severe sepsis.N Engl J Med. 1999; 340: 207-214
Published online: March 26, 2015
Accepted: March 18, 2015
Received in revised form: March 17, 2015
Received: December 10, 2014
© 2015 Elsevier B.V. Published by Elsevier Inc. All rights reserved.