C-Reactive Protein and Fibrinogen in Acute Stroke Patients with and without Sleep ApneaDziewas R. · Ritter M. · Krüger L. · Berger S. · Langer C. · Kraus J. · Dittrich R. · Schäbitz W.R. · Ringelstein E.B. · Young P.
aDepartment of Neurology, University Hospital of Münster, and bInstitute of Clinical Chemistry and Laboratory Medicine, Münster, Germany; cDepartment of Neurology, University Hospital Salzburg, Salzburg, Austria
Background and Purpose: Although sleep apnea (SA) is a risk factor for ischemic stroke and an important prognosticator in affected patients, the exact pathophysiological link between SA and stroke remains to be established. We investigated whether levels of C-reactive protein (CRP) and fibrinogen are increased in patients with acute stroke and SA compared with stroke patients without SA. Patients and Methods: 117 consecutive patients with ischemic stroke admitted to our stroke unit within 12 h after stroke onset were included in this study. On admission, CRP and fibrinogen levels were determined. All patients received cardiorespiratory polygraphy during the first 72 h of their hospital stay. In all patients, demographic data, National Institutes of Health Stroke Scale score and cerebrovascular risk factors were assessed. Results: SA defined by an apnea-hypopnea index (AHI) of ≧10/h was found in 64 (55%) patients. Elevated CRP and fibrinogen levels were seen twice as often in patients with SA than in patients without (CRP: 52 vs. 26%; fibrinogen: 72 vs. 37%). After multivariate logistic regression analysis, an AHI of ≧10/h was independently correlated with raised levels of both of these parameters. Conclusion: SA is independently associated with raised levels of CRP and fibrinogen in patients with acute ischemic stroke. We assume that both proteins are part of the pathophysiological pathway linking SA to stroke.
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