ROLE OF HIGH-SENSITIVITY C-REACTIVE PROTEIN IN PREDICTING STROKE AND CARDIOVASCULAR EVENTS: A META-ANALYSIS

Abstract

Background: Stroke stands as a prominent cause of morbidity and mortality on a global scale. Inflammation assumes a pivotal role in the advancement of stroke, with high-sensitivity C-reactive protein (hs-CRP) showing promise as a potential biomarker for assessing the risk of stroke. Aim: This meta-analysis seeks to evaluate the predictive capacity of hs-CRP in relation to stroke by comparing hs-CRP levels in stroke patients with those in non-stroke subjects (apparently healthy individuals) and patients with other cardiovascular events versus controls. Method: A comprehensive search across PubMed, Web of Science, EMBASE, and the Cochrane Library identified studies published from January 2010 to June 2024. Inclusion criteria focused on case control or cohort studies reporting quantitative hs-CRP levels in stroke and cardiovascular events alongside control groups. Studies were rigorously screened and selected based on predefined criteria (randomized control trials). Data from 13 selected studies were extracted and analyzed using RevMan 5.4.1 review manager. Findings: The meta-analysis included data from 13 studies with a total sample size of 1,486 subjects. The primary comparator analysis showed significantly higher hs-CRP levels in stroke patients than in non-stroke controls (Standardized Mean difference: 0.85 mg/L, 95% CI: 0.4,1.29; p= 0.0002). The secondary comparator analysis demonstrated elevated hs-CRP levels in patients who experienced other cardiovascular events compared to the control group (Standardized Mean Difference: 2.20 mg/L; 96% CI: 1.22, 3.18; p < 0.00001). These findings indicate that increased hs-CRP levels are associated with a heightened risk of stroke and other cardiovascular events. This underscores the potential of hs-CRP as a valuable biomarker in stroke and cardiovascular disease risk assessment. Conclusion: hs-CRP measurement can enhance stroke prediction models, facilitating early intervention and improving outcomes. Further research should focus on standardizing hs-CRP measurement protocols and exploring their integration into clinical practice.