Carotid plaque, stroke pathogenesis, and CRP: treatment of ischemic stroke.

C-reactive protein (CRP), an inflammatory marker, has been identified as a likely predictor of the risk of a future stroke. In clinical settings, it has been consistently observed that higher concentrations of CRP are associated with larger brain infarcts and worst neurologic outcome. However, there is still controversy over the degree of risk conferred by elevated CRP concentrations. CRP, like many other hemostatic factors, is an acute-phase protein and, therefore, it is not always clear whether its association with cerebrovascular disease reflects its contribution to atherothrombosis, its acute-phase condition, or both. Whether a reduction of CRP levels could be beneficial to stroke patients remains to be clarified. More studies are needed before CRP becomes a routine part of the evaluation of stroke patients.