Journal Article

Elevated high-sensitivity C-reactive protein levels are associated with intracranial arterial stenosis in elderly patients

Li, Mimi, Chen, Chunnuan, Liu, Shufen

2025

Overview

Background To determine the correlation between intracranial atherosclerotic stenosis and high-sensitivity C-reactive protein (hs-CRP) levels in elderly patients with cerebral infarction. Methods We performed a retrospective assessment of acute minor ischemic stroke patients aged over 60 at our institution from January 2021 to May 2023. A thorough computed tomography angiography (CTA) assessment was conducted for each participant. The patients were classified into four categories according to the site of stenosis in the cerebral arteries: (1) intracranial atherosclerotic stenosis (ICAS), (2) extracranial atherosclerotic stenosis (ECAS), (3) combined intracranial and extracranial atherosclerotic stenosis (IEAS), and (4) non-arterial stenosis (NOAS). Multivariate logistic regression analysis was utilized to evaluate the relationship between intracranial atherosclerotic stenosis and hs-CRP levels. The predictive efficacy of hs-CRP for intracranial arterial stenosis was assessed utilizing the Receiver Operating Characteristic (ROC) curve. Results The research comprised 203 participants in total. Among these, 73 individuals (34.96%) were categorized as having Intracranial Stenosis Atherosclerosis (ICAS). The hs-CRP levels in the ICAS group were markedly elevated ( P  = 0.011), while no significant difference in hs-CRP levels was observed between the ECAS and NOAS groups ( P  = 0.080). Hs-CRP levels were found to be independently correlated with intracranial arterial stenosis (OR 1.136, 95% CI 1.038–1.242, P  = 0.006) following multivariable analysis, as shown in Table 2. The upper quartile of hs-CRP was determined to be a statistically significant independent risk factor for intracranial stenosis (OR 3.779, 95% CI 1.519–9.402, P  = 0.004). The area under the curve (AUC) for hs-CRP was calculated to be 0.632 following the analysis of the ROC curve. The ideal cutoff value for hs-CRP was established at 3.96 mg/L, accompanied by a 95% confidence interval ranging from 0.555 to 0.710 ( P  = 0.001). The sensitivity and specificity were 0.500 and 0.735, respectively. Conclusions In elderly patients with acute minor ischemic stroke, elevated hs-CRP levels are significantly correlated with intracranial atherosclerosis stenosis, rather than extracranial atherosclerotic stenosis.

• Publisher: BioMed Central,BioMed Central Ltd,Springer Nature B.V,BMC
• Subject: Aged / Aged patients / Aged, 80 and over / Angiography / Arteriosclerosis / Atherosclerosis / Biomarkers - blood / Blood pressure / C-reactive protein / C-Reactive Protein - analysis / C-Reactive Protein - metabolism / Care and treatment / Carotid arteries / Cerebral infarction / Cholesterol / Computed tomography / Computed Tomography Angiography / Constriction, Pathologic - blood / Constriction, Pathologic - diagnostic imaging / Female / Health aspects / High-sensitivity C-reactive protein / Humans / Hypertension / Inflammation / Intracranial Arteriosclerosis - blood / Intracranial Arteriosclerosis - diagnostic imaging / Intracranial atherosclerosis stenosis / Ischemia / Ischemic Stroke - blood / Ischemic Stroke - diagnostic imaging / Lipoproteins / Male / Measurement / Medicine / Medicine & Public Health / Middle Aged / Mortality / Neurochemistry / Neurology / Neurosurgery / Older people / Prevention / Retrospective Studies / Risk factors / Senile patients / Statistical analysis / Statistical significance / Stenosis / Stroke / Stroke (Disease) / Tomography / Variables / Variance analysis / Veins & arteries