C-reactive protein test could predict risk of second stroke

Stephen Williams

Researchers have linked high levels of C-reactive protein (CRP) with increased risk for recurrent ischaemic stroke. Already used to measure people’s risk of developing coronary artery disease, the research suggests it could be a useful tool for ischaemic stroke patients as well.

“The biggest risk of death for someone who has already had a stroke is to have another one,” says University of Virginia School of Medicine (Charlottesville, USA) researcher Stephen Williams. “So it’s really important to be able to try and target those individuals who are at the highest risk for the thing that very well may kill them.”

To better understand ischemic stroke, Williams and his colleagues set out to determine how our genes affect the levels of biomarkers such as CRP in our blood. Not only did they find that elevated CRP levels suggest increased stroke risk, they identified gene variations that drive those risks.

“So we have the genetics influencing [CRP] levels, which then increases the risk of having a recurrent stroke. Then we went back and said alright, can we predict the increased risk purely based on the genetics, which we were able to do,” Williams says. “There’s this shared genetic susceptibility not only for increased C-Reactive Protein but for increased risk for stroke. We could estimate what’s called a hazard ratio – basically the increased risk for having or not having a second stroke – based on the genetics.”

Williams envisions a day when doctors might focus on CRP levels and a patient’s genetic makeup to determine their overall risk for a second stroke. But even CRP levels alone could be a useful tool in assessing risk after the initial stroke. “Getting a CRP measure on someone is really simple.” Williams says. “It’s not very expensive, and it’s part of routine workups that could be done for patients. However, combined with genetic information we may have even more power to identify those at greatest risk.”