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(Circulation. 1999;100:e66.)
© 1999 American Heart Association, Inc.

Circulation Electronic Pages

C-Reactive Protein After First-Ever Ischemic Stroke

Mario Di Napoli, MD; Giacinto Di Gianfilippo, MD; Vittorio Bocola, MD

Department of Neurology and Neurorehabilitation, Villa Pini d'Abruzzo, Casa di Cura, Chieti, Italy

	Introduction

 
To the Editor:

We would like to compliment Paul Ridker and colleagues on the interesting study published in Circulation¹ regarding the role of inflammation in secondary prevention after myocardial infarction and add further observations. In their study, Ridker and colleagues¹ found an intriguing association between evidence of inflammation after myocardial infarction and an increased risk of recurrent coronary events. Though the mechanism responsible for this increased risk was unclear, the authors' recommendation to stratify postinfarction patients into relatively high- and low-risk groups according to inflammation levels sounds appropriate considering that the relevance of inflammation in cardiovascular disease is not completely established,² and it encourages us to study the role of C-reactive protein (CRP) levels in short-term prognosis after first-ever ischemic stroke.

We studied 30 ischemic stroke patients (10 men and 20 women) between 49 and 90 years of age (mean±SD 72±10 years) within 4 weeks of their qualifying event who were prospectively included in the Villa Pini Stroke Data Bank, Chieti, Italy. To avoid confounding factors, no patients with evidence of acute infection were included in the series. CRP samples were collected a median of 14 days from stroke event. The mean±SD Canadian Neurological Stroke Scale score was 9.0±2.7.

Increased CRP levels were detected in all examined patients. There was a notable difference in the mean level of CRP between patients and our healthy control subjects (3.8 mg/dL [95% CI 1.4 to 6.1] versus 0.3 mg/dL [95% CI 0 to 0.5]). Higher CRP levels also correlated with a significant neurological . . . [Full Text of this Article]

Paul M. Ridker, MD; Marc A. Pfeffer, MD; Frank M. Sacks, MD; Eugene Braunwald, MD

Brigham and Women's Hospital, Harvard Medical School, Boston, Mass

Nader Rifai, PhD

Children's Hospital Medical Center Boston, Mass

Lemuel A. Moye, MD

University of Texas School of Public Health Houston, Tex

Steven Goldman, MD

Veterans Administration Medical Center Tucson, Ariz

Greg C. Flaker, MD

University of Missouri Columbia, Mo

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