Association of High-sensitivity C-reactive Protein with Patient Prognosis Following Mechanical Thrombectomy for Acute Ischemic Stroke

Abstract

Objective: The aim of this investigation was to examine the association of hsCRP (highsensitivity C-reactive protein) with outcomes and prognosis of patients who underwent mechanical thrombectomy (MT) for large vessel occlusion (LVO) after acute ischemic stroke (AIS). Methods: A total of 404 patients were enrolled, and outcomes included unfavorable clinical outcome at three months (modified Rankin Scale, mRS scores 3-6), the occurrence of symptomatic intracerebral hemorrhage (sICH) and hemorrhagic transformation (HT) of the infarct. Receiver operating characteristic (ROC) curve analysis was performed to identify the cutoff value of hsCRP to discriminate between favorable and unfavorable outcomes. The association of hsCRP with outcomes was evaluated using a logistic regression model. Results: The best cutoff value of hsCRP to distinguish between favorable and unfavorable outcomes at three months was identified as 3.0 mg/L (area under the curve, [AUC] 0.641, 95% confidence interval, [CI] 0.535-0.748; P = 0.014). In, multivariate analysis, patients with hsCRP ≥3 mg/L had more unfavorable outcome (odds ratio [OR] 1.72, 95% CI 1.42-2.02; P = 0.010), sICH (OR 2.64, 95% CI 1.62-3.66; P = 0.004), and HT of infarct (OR 1.72, 95% CI 1.42-2.02; P = 0.008) compared to those with hsCRP <1 mg/L. Conclusion: Our study demonstrates that patients with higher CRP levels had more unfavorable outcome, and exhibited higher sICH, and HT of infarct than those with lower CRP levels. Elevated hsCRP level, especially when higher than 3 mg/L, is an independent predictor for poor clinical prognosis in patients with MT for LVO.