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C-reactive protein is a determinant of first-ever stroke: prospective nested case-referent study.

Artikel i vetenskaplig tidskrift
Författare J. Andersson
Lars Johansson
Per Ladenvall
Per-Gunnar Wiklund
Birgitta Stegmayr
Christina Jern
Kurt Boman
Publicerad i Cerebrovascular diseases (Basel, Switzerland)
Volym 27
Nummer/häfte 6
Sidor 544-51
ISSN 1421-9786
Publiceringsår 2009
Publicerad vid Institutionen för neurovetenskap och fysiologi, sektionen för klinisk neurovetenskap och rehabilitering
Institutionen för medicin, avdelningen för akut och kardiovaskulär medicin
Sidor 544-51
Språk en
Länkar dx.doi.org/10.1159/000214217
Ämnesord Stroke, Intracerebral hemorrhage, C-reactive protein, Single-nucleotide polymorphism, Risk factor
Ämneskategorier Medicin och Hälsovetenskap

Sammanfattning

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.

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