C-reactive protein and long-term ischemic stroke prognosis

VanGilder, Reyna; Davidov, Danielle M.; Stinehart, Kyle; Huber, Jason D.; Turner, Ryan C.; Wilson, Kerry; Haney, Eric; Davis, Stephen M.; Chantler, Paul D.; Theeke, Laurie A.; Rosen, Charles L.; Crocco, Todd J.; Gutmann, Laurie; Barr, Taura L.

doi:10.1016/j.jocn.2013.06.015

Cited by 77 publications

(68 citation statements)

References 45 publications

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“…In their study, an elevated CRP level was significantly associated with poor outcome in patients with branch atheromatous disease, but they had a smaller sample size than the present study. Except for the study by Men et al [17], the results presented here are mainly in line with those of several previous studies [18,19,20]. However, these studies may be affected by the inclusion of other stroke subtypes and do not reflect the etiological characteristics of patients diagnosed with SAO.…”

Section: Discussionsupporting

confidence: 86%

An Elevated High-Sensitivity C-Reactive Protein Level Is Associated with Unfavorable Functional Outcomes of Small-Artery Occlusion in Patients without Diabetes

Gao

Liu²,

Wang³

et al. 2017

Eur Neurol

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Background: High-sensitivity C-reactive protein (hs-CRP) is associated with a risk of causing diabetes mellitus and ischemic stroke. However, the association between hs-CRP levels and functional outcome after small-artery occlusion (SAO) is unknown. Methods: Data for 836 patients diagnosed with SAO were collected from the Department of Neurorehabilitation of Huanhu Hospital. Hs-CRP values were classiﬁed according to quartiles (<0.67, 0.67 to <1.46, 1.46 to <3.46, and ≥3.46 mg/L). We examined the relationship between hs-CRP levels on admission and modified Rankin Scale (mRS) scores using univariate and multivariate analyses. We further performed subgroup analyses of patients with and without diabetes. Results: Patients in the highest hs-CRP quartile had a significantly higher risk of an unfavorable outcome. In the non-diabetes subgroup, the elevated hs-CRP quartiles were associated with higher mRS scores. In the diabetes subgroup, no statistically significant association was observed between hs-CRP levels and mRS. Conclusions: Elevated hs-CRP level on admission was associated with a poor functional outcome 3 months after SAO, especially among nondiabetes patients. However, no significant associations were observed in patients with diabetes.

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Section: Discussionsupporting

confidence: 86%

An Elevated High-Sensitivity C-Reactive Protein Level Is Associated with Unfavorable Functional Outcomes of Small-Artery Occlusion in Patients without Diabetes

Gao

Liu²,

Wang³

et al. 2017

Eur Neurol

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“…In Craft et al’s study, social isolation did not have an effect on intra-ischemic or post-ischemic corticosterone concentration, which suggests that corticosteroids are not sufficient to explain the effects of social isolation on ischemic outcome. However, intra-ischemic C-reactive protein (CRP) levels—an index of inflammation (Szalai, Nataf, Hu, & Barnum, 2002) and a potential risk-factor for stroke (Chaudhuri et al, 2013; Lindsberg & Grau, 2003; VanGilder et al, 2014) and increased cerebral infarct size (Gill, Kemp, Sabin, & Pepys, 2004)—were higher in socially isolated male mice relative to pair-housed male mice (Craft et al, 2005). …”

Section: Social Isolation: Animal Models and Paradigmsmentioning

confidence: 99%

Toward a neurology of loneliness.

Cacioppo

Capitanio

Cacioppo

2014

Psychological Bulletin

393

313

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Social isolation has been recognized as a major risk factor for morbidity and mortality in humans for more than a quarter century. The brain is the key organ of social connections and processes, however, and the same objective social relationship can be experienced as caring and protective or as exploitive and isolating. We review evidence that the perception of social isolation (i.e., loneliness) impacts brain and behavior and is a risk factor for broad-based morbidity and mortality. However, the causal role of loneliness on neural mechanisms and mortality is difficult to test conclusively in humans. Mechanistic animal studies provide a lens through which to evaluate the neurological effects of a member of a social species living chronically on the social perimeter. Experimental studies show that social isolation produces significant changes in brain structures and processes in adult social animals. These effects are not uniform across the brain or across species but instead are most evident in brain regions that reflect differences in the functional demands of solitary versus social living for a particular species. The human and animal literatures have developed independently, however, and significant gaps also exist. The current review underscores the importance of integrating human and animal research to delineate the mechanisms through which social relationships impact the brain, health, and well-being.

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“…Until recently, research focused primarily on the inflammatory response within the peri-infarct region after stroke, but it is now clear that stroke also leads to a profound systemic inflammatory response. Following stroke, there is an increase in inflammatory biomarkers in the bloodstream [2,3], but at the same time activation of the sympathetic nervous system mediates a systemic immunodepression that includes a defect in the T helper 1 response [4,5]. This sympathetically mediated immunodepression likely contributes to an increase in the risk of poststroke infection [6].…”

mentioning

confidence: 99%