C-Reactive Protein Is a Determinant of First-Ever Stroke: Prospective Nested Case-Referent StudyAndersson J.a, b · Johansson L.a, b · Ladenvall P.c · Wiklund P.-G.b · Stegmayr B.b · Jern C.d · Boman K.a, b
aDepartment of Medicine and Geriatrics, Skellefteå County Hospital, Skellefteå, bDepartment of Public Health and Clinical Medicine, Umeå University, Umeå, cClinical Experimental Research Laboratory, Department of Emergency and Cardiovascular Medicine, Institute of Medicine, and dInstitute of Neuroscience and Physiology, Sahlgrenska Academy at University of Gothenburg, Göteborg, Sweden
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Background and Purpose: C-reactive protein (CRP) is a determinant of stroke, but there are no prospective studies on CRP and first ischemic stroke divided into etiologic subtypes. Our primary aim was to study CRP as a determinant of ischemic stroke, classified according to Trial of ORG 10172 in Acute Stroke Treatment (TOAST) criteria, and intracerebral hemorrhage (ICH) in a prospective study. A secondary aim was to study the relationship between the 1444C>T polymorphism, plasma levels of CRP and stroke. Methods: The study was a prospective population-based case-referent study nested within the Northern Sweden Cohorts. We defined 308 cases of ischemic stroke and 61 ICH. Two controls for each case were defined from the same cohort. Results: The OR for the highest (>3 mg/l) versus lowest group (<1 mg/l) of CRP was 2.58 (95% CI 1.74–3.84) for ischemic stroke and 1.63 (95% CI 0.67–3.93) for ICH. In a multivariate model including traditional risk factors, CRP remained associated with ischemic stroke (OR 2.06; 95% CI 1.29–3.29). Small-vessel disease was associated with CRP in the multivariate model (OR 3.88; 95% CI 1.10–13.7). The CRP 1444 (CC/CT vs. TT) polymorphism was associated with plasma levels of CRP but neither with ischemic stroke nor with ICH. Conclusions: This prospective population-based study shows that CRP is significantly associated with the risk of having a first ischemic stroke, especially for small-vessel disease. No significant associations were found between the CRP 1444C>T polymorphism and any stroke subtype.
© 2009 S. Karger AG, Basel
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