Background and Purpose Inflammatory biomarkers predict incident and recurrent cardiac events, but their relationship to stroke prognosis is uncertain. We hypothesized that high-sensitivity C-reactive protein (hsCRP) predicts recurrent ischemic stroke after recent lacunar stroke. Methods Levels of Inflammatory Markers in the Treatment of Stroke (LIMITS) was an international, multicenter, prospective ancillary biomarker study nested within Secondary Prevention of Small Subcortical Strokes (SPS3), a Phase III trial in patients with recent lacunar stroke. Patients were assigned in factorial design to aspirin versus aspirin plus clopidogrel, and higher versus lower blood pressure targets. Patients had blood samples collected at enrollment, and hsCRP measured using nephelometry at a central laboratory. Cox proportional hazards models were used to calculate hazard ratios and 95% confidence intervals (HR, 95%CI) for recurrence risks before and after adjusting for demographics, comorbidities, and statin use. Results Among 1244 lacunar stroke patients (mean 63.3 ± 10.8 years), median hsCRP was 2.16 mg/L. There were 83 recurrent ischemic strokes (including 45 lacunes), and 115 major vascular events (stroke, myocardial infarction, vascular death). Compared with the bottom quartile, those in the top quartile (hsCRP >4.86 mg/L) were at increased risk of recurrent ischemic stroke (unadjusted HR 2.54, 95%CI 1.30–4.96), even after adjusting for demographics and risk factors (adjusted HR 2.32, 95%CI 1.15–4.68). HsCRP predicted increased risk of major vascular events (top quartile adjusted HR 2.04, 95%CI 1.14–3.67). There was no interaction with randomized antiplatelet treatment. Conclusions Among recent lacunar stroke patients, hsCRP levels predict risk of recurrent strokes and other vascular events. HsCRP did not predict response to dual antiplatelets.

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This study investigated the relationship between inherent muscle length and torque production in 59 healthy women. We recorded nondominant ankle range-of-motion values for each subject. These values were partitioned into quartiles for two knee positions. Women with "loose" plantar flexor muscles comprised the first quartile, and those with "tight" plantar flexor muscles the fourth quartile. Tight- and loose-muscle groups were established for the 0-degree (fully extended) and 90-degree (flexed) knee test positions for data analysis. Torque measurements were obtained using an isokinetic testing apparatus. We asked each subject to perform a maximal isometric (static) plantar flexion contraction at each of three ankle positions: 7 degrees of dorsiflexion (angle A), 0 degrees or neutral (angle B), and 30 degrees of plantar flexion (angle C). Data analysis was performed using an analysis of variance for repeated measures. Results indicated that torque produced by the tight-muscle groups was significantly greater than the torque produced by the loose-muscle groups at both knee positions (p less than .05). Additionally, the ankle ROM data obtained suggest normative data different from those currently prevalent in the literature. Findings of this study may prove valuable in the rehabilitation of ankle injuries and could be beneficial especially to physical therapists in understanding more about normal ankle function.