Relationship between C - Reactive protein and stroke

A large prospective community based study

Yanfang Liu, Jing Wang, Liqun Zhang, Chunxue Wang, Jianwei Wu, Yong Zhou, Xiang Gao, Anxin Wang, Shouling Wu, Xingquan Zhao

Research output: Contribution to journalArticle

18 Citations (Scopus)

Abstract

Objective: Previous studies have suggested that C-reactive protein (CRP) was associated with risk of stroke. There were few studies in Asian population, or on stroke subtypes other than ischemic stroke. We thus investigated the relationship between CRP and the risks of all stroke and its subtypes in a Chinese adult population. Methods: In the current study, we included 90,517 Chinese adults free of stroke and myocardial infarction at baseline (June 2006 to October 2007) in analyses. Strokes were classified as ischemic stroke (IS), intracranial heamorrhage (ICH) and subarachnoid heamorrhage (SAH). High-sensitivity CRP (hs-CRP) were categorized into three groups: <1 mg/L, 1 to 3 mg/L, and >3 mg/L. Cox proportional hazards regression was used to calculate the association between hs-CRP concentrations and all stroke, as well as its subtypes. Results: During a median follow-up time of 49 months, we documented 1,472 incident stroke cases. Of which 1,049 (71.3%) were IS, 383 (26.0%) were ICH, and 40 (2.7%) were SAH. After multivariate adjustment, hs-CRP concentrations ≥1 mg/L were associated with increased risks of all stroke (hs-CRP 1-3 mg/L: hazard ratio (HR) 1.17, 95% confidential interval (CI) 1.03-1.33; hs-CRP>3 mg/L: HR 1.25, 95% CI 1.07-1.46) and IS (hs-CRP 1-3 mg/L: HR 1.17, 95% CI 1.01-1.36; hs-CRP>3 mg/L: HR 1.33, 95% CI 1.11-1.60), but not with ICH and SAH. Subgroup analyses showed that higher hs-CRP concentration was more prone to be a risk factor for all stroke and IS in non-fatal stroke, male and hypertensive participants. Conclusion: We found that higher hs-CRP concentrations were associated with a higher risk of IS, particularly for non-fatal stroke, male and hypertensive subjects. In contrast, we did not observe significant associations between hs-CRP and ICH/SAH.

Original languageEnglish (US)
Article numbere107017
JournalPloS one
Volume9
Issue number9
DOIs
StatePublished - Sep 5 2014

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C-reactive protein
stroke
C-Reactive Protein
Hazards
Stroke
myocardial infarction

All Science Journal Classification (ASJC) codes

  • Biochemistry, Genetics and Molecular Biology(all)
  • Agricultural and Biological Sciences(all)

Cite this

Liu, Y., Wang, J., Zhang, L., Wang, C., Wu, J., Zhou, Y., ... Zhao, X. (2014). Relationship between C - Reactive protein and stroke: A large prospective community based study. PloS one, 9(9), [e107017]. https://doi.org/10.1371/journal.pone.0107017
Liu, Yanfang ; Wang, Jing ; Zhang, Liqun ; Wang, Chunxue ; Wu, Jianwei ; Zhou, Yong ; Gao, Xiang ; Wang, Anxin ; Wu, Shouling ; Zhao, Xingquan. / Relationship between C - Reactive protein and stroke : A large prospective community based study. In: PloS one. 2014 ; Vol. 9, No. 9.
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title = "Relationship between C - Reactive protein and stroke: A large prospective community based study",
abstract = "Objective: Previous studies have suggested that C-reactive protein (CRP) was associated with risk of stroke. There were few studies in Asian population, or on stroke subtypes other than ischemic stroke. We thus investigated the relationship between CRP and the risks of all stroke and its subtypes in a Chinese adult population. Methods: In the current study, we included 90,517 Chinese adults free of stroke and myocardial infarction at baseline (June 2006 to October 2007) in analyses. Strokes were classified as ischemic stroke (IS), intracranial heamorrhage (ICH) and subarachnoid heamorrhage (SAH). High-sensitivity CRP (hs-CRP) were categorized into three groups: <1 mg/L, 1 to 3 mg/L, and >3 mg/L. Cox proportional hazards regression was used to calculate the association between hs-CRP concentrations and all stroke, as well as its subtypes. Results: During a median follow-up time of 49 months, we documented 1,472 incident stroke cases. Of which 1,049 (71.3{\%}) were IS, 383 (26.0{\%}) were ICH, and 40 (2.7{\%}) were SAH. After multivariate adjustment, hs-CRP concentrations ≥1 mg/L were associated with increased risks of all stroke (hs-CRP 1-3 mg/L: hazard ratio (HR) 1.17, 95{\%} confidential interval (CI) 1.03-1.33; hs-CRP>3 mg/L: HR 1.25, 95{\%} CI 1.07-1.46) and IS (hs-CRP 1-3 mg/L: HR 1.17, 95{\%} CI 1.01-1.36; hs-CRP>3 mg/L: HR 1.33, 95{\%} CI 1.11-1.60), but not with ICH and SAH. Subgroup analyses showed that higher hs-CRP concentration was more prone to be a risk factor for all stroke and IS in non-fatal stroke, male and hypertensive participants. Conclusion: We found that higher hs-CRP concentrations were associated with a higher risk of IS, particularly for non-fatal stroke, male and hypertensive subjects. In contrast, we did not observe significant associations between hs-CRP and ICH/SAH.",
author = "Yanfang Liu and Jing Wang and Liqun Zhang and Chunxue Wang and Jianwei Wu and Yong Zhou and Xiang Gao and Anxin Wang and Shouling Wu and Xingquan Zhao",
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Liu, Y, Wang, J, Zhang, L, Wang, C, Wu, J, Zhou, Y, Gao, X, Wang, A, Wu, S & Zhao, X 2014, 'Relationship between C - Reactive protein and stroke: A large prospective community based study', PloS one, vol. 9, no. 9, e107017. https://doi.org/10.1371/journal.pone.0107017

Relationship between C - Reactive protein and stroke : A large prospective community based study. / Liu, Yanfang; Wang, Jing; Zhang, Liqun; Wang, Chunxue; Wu, Jianwei; Zhou, Yong; Gao, Xiang; Wang, Anxin; Wu, Shouling; Zhao, Xingquan.

In: PloS one, Vol. 9, No. 9, e107017, 05.09.2014.

Research output: Contribution to journalArticle

TY - JOUR

T1 - Relationship between C - Reactive protein and stroke

T2 - A large prospective community based study

AU - Liu, Yanfang

AU - Wang, Jing

AU - Zhang, Liqun

AU - Wang, Chunxue

AU - Wu, Jianwei

AU - Zhou, Yong

AU - Gao, Xiang

AU - Wang, Anxin

AU - Wu, Shouling

AU - Zhao, Xingquan

PY - 2014/9/5

Y1 - 2014/9/5

N2 - Objective: Previous studies have suggested that C-reactive protein (CRP) was associated with risk of stroke. There were few studies in Asian population, or on stroke subtypes other than ischemic stroke. We thus investigated the relationship between CRP and the risks of all stroke and its subtypes in a Chinese adult population. Methods: In the current study, we included 90,517 Chinese adults free of stroke and myocardial infarction at baseline (June 2006 to October 2007) in analyses. Strokes were classified as ischemic stroke (IS), intracranial heamorrhage (ICH) and subarachnoid heamorrhage (SAH). High-sensitivity CRP (hs-CRP) were categorized into three groups: <1 mg/L, 1 to 3 mg/L, and >3 mg/L. Cox proportional hazards regression was used to calculate the association between hs-CRP concentrations and all stroke, as well as its subtypes. Results: During a median follow-up time of 49 months, we documented 1,472 incident stroke cases. Of which 1,049 (71.3%) were IS, 383 (26.0%) were ICH, and 40 (2.7%) were SAH. After multivariate adjustment, hs-CRP concentrations ≥1 mg/L were associated with increased risks of all stroke (hs-CRP 1-3 mg/L: hazard ratio (HR) 1.17, 95% confidential interval (CI) 1.03-1.33; hs-CRP>3 mg/L: HR 1.25, 95% CI 1.07-1.46) and IS (hs-CRP 1-3 mg/L: HR 1.17, 95% CI 1.01-1.36; hs-CRP>3 mg/L: HR 1.33, 95% CI 1.11-1.60), but not with ICH and SAH. Subgroup analyses showed that higher hs-CRP concentration was more prone to be a risk factor for all stroke and IS in non-fatal stroke, male and hypertensive participants. Conclusion: We found that higher hs-CRP concentrations were associated with a higher risk of IS, particularly for non-fatal stroke, male and hypertensive subjects. In contrast, we did not observe significant associations between hs-CRP and ICH/SAH.

AB - Objective: Previous studies have suggested that C-reactive protein (CRP) was associated with risk of stroke. There were few studies in Asian population, or on stroke subtypes other than ischemic stroke. We thus investigated the relationship between CRP and the risks of all stroke and its subtypes in a Chinese adult population. Methods: In the current study, we included 90,517 Chinese adults free of stroke and myocardial infarction at baseline (June 2006 to October 2007) in analyses. Strokes were classified as ischemic stroke (IS), intracranial heamorrhage (ICH) and subarachnoid heamorrhage (SAH). High-sensitivity CRP (hs-CRP) were categorized into three groups: <1 mg/L, 1 to 3 mg/L, and >3 mg/L. Cox proportional hazards regression was used to calculate the association between hs-CRP concentrations and all stroke, as well as its subtypes. Results: During a median follow-up time of 49 months, we documented 1,472 incident stroke cases. Of which 1,049 (71.3%) were IS, 383 (26.0%) were ICH, and 40 (2.7%) were SAH. After multivariate adjustment, hs-CRP concentrations ≥1 mg/L were associated with increased risks of all stroke (hs-CRP 1-3 mg/L: hazard ratio (HR) 1.17, 95% confidential interval (CI) 1.03-1.33; hs-CRP>3 mg/L: HR 1.25, 95% CI 1.07-1.46) and IS (hs-CRP 1-3 mg/L: HR 1.17, 95% CI 1.01-1.36; hs-CRP>3 mg/L: HR 1.33, 95% CI 1.11-1.60), but not with ICH and SAH. Subgroup analyses showed that higher hs-CRP concentration was more prone to be a risk factor for all stroke and IS in non-fatal stroke, male and hypertensive participants. Conclusion: We found that higher hs-CRP concentrations were associated with a higher risk of IS, particularly for non-fatal stroke, male and hypertensive subjects. In contrast, we did not observe significant associations between hs-CRP and ICH/SAH.

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U2 - 10.1371/journal.pone.0107017

DO - 10.1371/journal.pone.0107017

M3 - Article

VL - 9

JO - PLoS One

JF - PLoS One

SN - 1932-6203

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