Yu Zhao, Yutong Wang, Shengyuan Wang
Baseline CRP was independently associated with 12-month mortality and, more weakly, with recurrence. The mortality association was substantially stronger, and CRP should be regarded primarily as a marker of long-term mortality risk. NLR and MLR showed no independent association with either endpoint. CRP, combined with key clinical indicators, may assist long-term risk stratification after ischaemic stroke.
BACKGROUND AND OBJECTIVE: C-reactive protein (CRP), the neutrophil-to-lymphocyte ratio (NLR) and the monocyte-to-lymphocyte ratio (MLR) are routinely available inflammatory markers of uncertain relative prognostic value after stroke. This study aimed to investigate the associations of baseline CRP, NLR, and MLR with 12-month mortality and recurrence in patients with stroke.
METHODS: This single-center prospective cohort study enrolled hospitalized patients with stroke. Univariable analyses were performed to compare baseline characteristics according to 12-month mortality and recurrence status. Multivariable logistic regression models were constructed to evaluate the independent associations of CRP, NLR, and MLR with 12-month mortality and recurrence after adjustment for clinically relevant covariates.
RESULTS: A total of 2937 patients were included in the baseline analysis. Among them, 2166 were included in the 12-month mortality analysis, and 237 died during follow-up. In the multivariable logistic regression model, higher CRP was independently associated with an increased risk of 12-month mortality (OR = 1.01, 95% CI: 1.01-1.02, P < 0.001). NLR showed a borderline association with mortality (OR = 1.06, 95% CI: 1.00-1.13, P = 0.064), whereas MLR was not independently associated with mortality. A total of 2018 patients were included in the 12-month recurrence analysis, among whom 614 experienced recurrent events. In the multivariable model, higher CRP was independently associated with an increased risk of recurrence (OR = 1.01, 95% CI: 1.00-1.02, P = 0.025), whereas NLR and MLR was not independently associated with recurrence.
CONCLUSION: Baseline CRP was independently associated with 12-month mortality and, more weakly, with recurrence. The mortality association was substantially stronger, and CRP should be regarded primarily as a marker of long-term mortality risk. NLR and MLR showed no independent association with either endpoint. CRP, combined with key clinical indicators, may assist long-term risk stratification after ischaemic stroke.