X Liu1, B Wang1, X Wang1, M Tian1, X Wang1, Y Zhang2. 1. Department of Neurology, First Affiliated Hospital of Zhengzhou University, Zhengzhou, China. 2. Department of Emergency, First Affiliated Hospital of Zhengzhou University, Zhengzhou, China.
Abstract
BACKGROUND AND PURPOSE: Post-stroke fatigue (PSF) is a common neuropsychiatric affective symptom occurring after stroke. Evidence indicates activated inflammatory pathways are involved in modulating the stroke and fatigue. High-sensitivity C-reactive protein (hs-CRP) is one of the most sensitive indicators of inflammation. Our aim was to estimate the association between plasma hs-CRP and PSF after acute ischaemic stroke. METHODS: In all, 212 acute ischaemic stroke patients were consecutively recruited within the first 14 days after stroke onset and followed up for 6 months. Plasma hs-CRP levels were assayed by enzyme linked immunosorbent assay. Fatigue severity was assessed using the Fatigue Scale for Motor and Cognitive Functions. A score ≥ 43 is defined as PSF. RESULTS: Sixty-eight stroke patients (32.1%) were diagnosed with PSF at 6 months' follow-up. In the patients with PSF, plasma hs-CRP levels were significantly higher compared with those in non-PSF patients (t = -8.524, P ≤ 0.001). In multivariate analyses, plasma levels of hs-CRP were independently associated with PSF at 6 months (odds ratio 3.435, 95% confidence interval 2.222-5.309; P ≤ 0.001) after adjusting other recorded variables. Based on the receiver operating characteristic curve, the optimal cut-off value of plasma hs-CRP levels as an indicator for the prediction of PSF was projected to be 0.52 mg/dl, which yielded a sensitivity of 77.9% and a specificity of 74.3%, with the area under the curve 0.794 (95% confidence interval 0.725-0.864; P ≤ 0.001). CONCLUSION: Elevated plasma hs-CRP levels at admission were associated with PSF 6 months after stroke, suggesting that these alterations might predict the development of PSF in stroke patients.
BACKGROUND AND PURPOSE: Post-stroke fatigue (PSF) is a common neuropsychiatric affective symptom occurring after stroke. Evidence indicates activated inflammatory pathways are involved in modulating the stroke and fatigue. High-sensitivity C-reactive protein (hs-CRP) is one of the most sensitive indicators of inflammation. Our aim was to estimate the association between plasma hs-CRP and PSF after acute ischaemic stroke. METHODS: In all, 212 acute ischaemic strokepatients were consecutively recruited within the first 14 days after stroke onset and followed up for 6 months. Plasma hs-CRP levels were assayed by enzyme linked immunosorbent assay. Fatigue severity was assessed using the Fatigue Scale for Motor and Cognitive Functions. A score ≥ 43 is defined as PSF. RESULTS: Sixty-eight strokepatients (32.1%) were diagnosed with PSF at 6 months' follow-up. In the patients with PSF, plasma hs-CRP levels were significantly higher compared with those in non-PSF patients (t = -8.524, P ≤ 0.001). In multivariate analyses, plasma levels of hs-CRP were independently associated with PSF at 6 months (odds ratio 3.435, 95% confidence interval 2.222-5.309; P ≤ 0.001) after adjusting other recorded variables. Based on the receiver operating characteristic curve, the optimal cut-off value of plasma hs-CRP levels as an indicator for the prediction of PSF was projected to be 0.52 mg/dl, which yielded a sensitivity of 77.9% and a specificity of 74.3%, with the area under the curve 0.794 (95% confidence interval 0.725-0.864; P ≤ 0.001). CONCLUSION: Elevated plasma hs-CRP levels at admission were associated with PSF 6 months after stroke, suggesting that these alterations might predict the development of PSF in strokepatients.