Abstract 2180: Inflammatory and Haemostatic Markers in Relation to Short-Term Risk for Death in Ischaemic Stroke Patients
Background: There is increasing evidence that inflammation and hypercoagulability play an important role in the pathophysiology of acute ischaemic stroke. We examined the in-hospital prognostic value on mortality of C-reactive protein (CRP), tumor necrosis factor-α (TNF-α), fibrinogen and D-dimer in patients with ischaemic stroke.
Methods: We recruited 231 consecutive patients <66 years of age who were admitted to the Neurology Department with the diagnosis of acute non-haemorrhagic stroke. Patients in atrial fibrillation were excluded. CRP, TNF-α, fibrinogen and D-dimer levels were determined within 12 hours from admission.
Results: Fifteen (6.5%) patients died during hospitalization. CRP, fibrinogen and D-dimer levels were significantly higher in patients who died compared with those who survived (Table⇓) but only CRP and fibrinogen were independently associated with early death, after adjusting for various confounding factors. For one unit increase in CRP there was a 20% higher risk of dying while for 10 mg/dl increase in fibrinogen the additive risk was 18%. Akaike Information Criterion showed that CRP levels had better prognostic value compared with fibrinogen levels. Cut-off point analysis revealed that CRP levels >22 mg/l and fibrinogen levels >490 mg/dl were the optimal points that discriminated those who died from the rest. Moreover, CRP levels were positively correlated with fibrinogen and D-dimer levels (r = 0.64, p<0.001 and r = 0.19, p = 0.01, respectively).
Conclusions: CRP and fibrinogen levels can predict independently the risk of early death in ischaemic stroke patients emphasizing the role of inflammation and coagulation in the evolution of ischaemic stroke.