Relationship between high-sensitivity C-reactive protein and early neurological deterioration in stroke patients with and without atrial fibrillation

Background and purpose The association of high-sensitivity C-reactive protein (hsCRP) with early neurological deterioration (END) is unclear, especially in stroke patients with atrial fibrillation (AF). In this study, we aimed to assess the association of baseline hsCRP levels with END in acute ischemic stroke with and without AF. Methods Consecutive acute ischemic stroke patients prospectively recruited from the Affiliated Hospital of Yangzhou University were analyzed and divided into two groups: AF related stroke (AF-S) and non-AF related stroke (Non-AF-S) groups. Plasma hsCRP levels on admission were categorized into three risk groups: low (<1.0 mg/L), average (1–3 mg/L) and high (>3 mg/L). Results A total of 655 consecutive patients diagnosed acute ischemic stroke were prospectively registered from our department in 2015–2018, which included 168 AF-S and 487 Non-AF-S cases. After standard therapy, 62 AF-S and 155 Non-AF-S cases developed END within 72 h of hospitalization. In AF-S cases, statistical differences between END and Non-END patients were found in age, gender, baseline National Institute of Health Stroke Scale (NIHSS) score, fasting blood glucose, responsible artery occlusion, CHA2DS2-VASc score and hsCRP level (p < 0.05). When variates showing p ≤ 0.1 in univariate analysis were adjusted, logistics regression analysis revealed following indexes as independent risk factors for END in AF-S patients: female (OR = 2.396, 95%CI:1.062–5.405, P = 0.035), fasting blood glucose (OR = 1.192, 95%CI:1.026–1.385, P = 0.022), responsible artery occlusion (OR = 3.589, 95%CI 1.425–9.036, P = 0.007), and high risk hsCRP (OR = 2.780, 95%CI 1.067–7.240, P = 0.036). In the Non-AF group, any level of hsCRP was not independently related to END after adjustment for age, sex, diabetes mellitus, smoking, baseline NIHSS, lesion size and responsible artery occlusion. Conclusion High hsCRP level was independently correlated with END in patients with AF-S.