High-sensitivity C-reactive protein, lipoprotein-related phospholipase A2, and acute ischemic stroke

Abstract

BackgroundSerum biomarkers may be useful for early diagnosis of acute ischemic stroke, exclusion of other diseases that may mimic stroke, and prediction of infarct volume. We evaluated serum high-sensitivity C-reactive protein (hs-CRP) and lipoprotein-related phospholipase A2 (Lp-PLA2) in patients who had acute ischemic stroke.MethodsIn 200 patients who presented to an emergency service (acute ischemic stroke, 102 patients; control with no stroke, 98 patients), stroke patients were evaluated with the Canadian neurological scale and diffusion-weighted magnetic resonance imaging, and all patients were evaluated with the Glasgow coma scale and their serum hs-CRP level and Lp-PLA2 activity were assessed. The volume of stroke lesions was calculated from magnetic resonance images.ResultsPatients who had stroke had higher mean serum hs-CRP level (stroke, 7±6 mg/dL; control, mean ± standard deviation 1±1 mg/dL; P≤0.001) and Lp-PLA2 activity (stroke, mean ± standard deviation 113±86 nmol/min/mL; control, mean ± standard deviation 103±50 nmol/min/mL; P≤0.001) than control patients who did not have stroke. The mean hs-CRP level and Lp-PLA2 activity were higher in patients who had greater stroke severity (lower Canadian neurological scale score) and were higher in patients who had larger volume strokes.ConclusionHigher hs-CRP level and Lp-PLA2 activity are significantly associated with more severe neurologic impairment and larger infarct size in patients who have acute ischemic stroke. These biomarkers may be useful for rapid diagnosis and prediction of ischemic tissue volume in the early stage of ischemic stroke. These findings may be important for health care facilities that have limited access to emergency computed tomography scanning for the diagnosis of stroke.

Upregulated Serum MiR-146b Serves as a Biomarker for Acute Ischemic Stroke

“…The combination of hs-CRP and D-dimer improves the diagnosis accuracy of cardioembolism in the acute phase [27]. Higher hs-CRP level and lipoproteinrelated phospholipase A2 (Lp-PLA2) activity are significantly associated with more severe neurologic impairment and larger infarct size in patients who have acute ischemic stroke [28].…”

Comparison of serum Lp‐PLA2 levels in ischemic stroke patients with H‐type hypertension or non‐H‐type hypertension

“…A recent study showed that Lp‐PLA2 can serve as a new inflammation marker associated with ischemic stroke. It may be directly involved in atherosclerosis, and it is able to independently forecast cerebrovascular events …”

Lipoprotein-associated phospholipase-A 2 activity and its diagnostic potential in patients with acute coronary syndrome and acute ischemic stroke

“…An association was found between Lp-PLA2 levels and stroke severity and infarction size. The authors state that they included the acute stroke patients who admit to emergency department within the first 24 h following symptom onset however they do not provide a detailed information about the time to obtain blood samples 5 . Tai et al.…”

“…The purpose of these studies was to determine the utility of Lp-PLA 2 in risk prediction or risk classification of cardiovascular diseases (CVDs) 4 . To the best of our knowledge the literature contains few studies on the diagnostic use of the Lp-PLA 2 level in patients with acute coronary syndrome (ACS) or acute ischemic stroke (AIS) 5, 6. As such, the present study aimed to examine the Lp-PLA 2 activity and its diagnostic potential in early period ACS and AIS patients.…”