[C-reactive protein and carotid intima-media thickness in atherothrombotic ischemic stroke].

BACKGROUND AND OBJECTIVE

We aimed to investigate the relation between values of C-reactive protein (CRP) and carotid artery intima-media thickness (IMT) in patients with atherothrombotic ischemic stroke.

PATIENTS AND METHOD

One hundred and thirty five patients within 48h after index ischemic stroke were included. CRP levels were obtained at this time and a carotid ultrasonography was performed. Neurological and functional disability were evaluated, and all patients underwent a cardiovascular risk stratification. Patients were divided in three groups according to the tertiles of they IMT distribution. We adjusted for the possible confounding effect using a multivariate logistic model.

RESULTS

Forty three in-patients were classified into group 1 (IMT between 0.7 and 1.1 millimetres), 43 into group 2 (IMT between 1.2 and 1.5 millimetres) and 49 into group 3 (IMT higher of 1.6 millimetres). We found a significant elevation of CRP levels at different groups (p<0.0008), with medians by group of 0.3, 0.4 and 1.5mg/dl respectively. Likewise, we found significant differences by group in functional disability (p<0.03) and in vascular risk stratification (p<0.02).

CONCLUSIONS

CRP is a marker of increased IMT in patients with atherothrombotic ischemic stroke. A cutoff point of 1.5mg/dl for CRP provided a greater IMT and a worse outcome in functional disability as cardiovascular risk. Therefore, this group requires a more intensive treatment in secondary prevention.