C-reactive protein in Stroke-Heart-Syndrome: a propensity-matched analysis of a global federated health network

Abstract Introduction The role of inflammation in the Stroke-Heart-Syndrome is unclear. Purpose To assess the predictive role of C-Reactive Protein (CRP) for early cardiovascular complications in patients with stroke. Methods Electronic medical records from TriNetX, a global federated health research network, were used for this retrospective analysis. Patients with ischemic stroke and CRP levels measured within 24 hours post-stroke, were categorized into three groups: i)3mg/L. The primary outcome was a composite outcome of cardiac complications (heart failure (HF), atrial fibrillation (AF), ischemic heart disease, ventricular arrhythmias, and Takotsubo cardiomyopathy) or death at 30 days from the index event. Cox-regression analyses were used to produce hazard ratios (HRs) and 95% confidence intervals (CI) following 1:1 propensity score matching. Results Of the 104,741 patients enrolled, 51% were female and the mean age was 67±2 years. Cardiac complications or death within 30 days occurred in 40.4% patients with CRP>3 mg/L, in 27.6% patients with CRP 1-3 mg/L and in 23.2% patients with CRP3mg/L had higher risk of the composite outcome (HR: 1.10, 95%CI: 1.05-1.50;HR: 1.51, 95%CI: 1.45-1.58), death (HR:1.43, 95%CI:1.24-1.64; HR:3.50, 95%CI:3.10-3.96), HF (HR:1.08, 95%CI:1.01-1.16; HR:1.51, 95%CI:1.41-1.61), AF (HR:1.10, 95% CI:1.02-1.18; HR:1.42, 95%CI:1.33-1.52), and ventricular arrhythmias (HR:1.24, 95% CI:1.02-1.52, HR:1.67, 95% CI:1.39-2.01) compared to those with CRP3mg/L (HR:1.33, 95% CI:1.26-1.40) compared to those with CRP