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Testing for CRP could identify patients at risk for recurrent stroke
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Researchers have identified genetic contributions to circulating levels of C-reactive protein in patients with stroke, which could help identify those at risk for recurrent ischemic stroke.
They conducted genomic scans on 2,100 participants from the VISP trial, all of whom had measures of C-reactive protein (CRP), fibrinogen, creatinine, prothrombin fragments F1 and F2, thrombin-antithrombin complex and thrombomodulin collected at baseline.
They examined the relationships between those biomarkers, genetic variants and stroke in the VISP population as well as the METASTROKE cohort of 12,389 people with ischemic stroke and 62,004 controls.
Stephen R. Williams, PhD, from the Center for Public Health Genomics and the Cardiovascular Research Center at the University of Virginia School of Medicine, Charlottesville, and colleagues found an association between CRP single nucleotide polymorphisms and circulating CRP levels. The most associated variant was rs2592902 (P = 1.14 x 10-9).
Stephen R. Williams
They also discovered a novel association related to CRP level in the AKR1D1 locus, the variant rs2589998 (P = 7.3 x 10-8).
In addition, Williams and colleagues determined that three CRP variants — rs3093068, rs16842599 and rs11265260 — were associated with ischemic stroke, recurrent stroke and stroke subtypes.
“So we have the genetics influencing CRP levels, which then increases the risk of having a recurrent stroke,” Williams said in a press release. “Then we went back and said alright, can we predict the increased risk purely based on the genetics, which we were able to do. There’s this shared genetic susceptibility not only for increased [CRP] but for increased risk for stroke. We could estimate [a HR] based on the genetics.”
He said that there may come a day when doctors use a genetic test and a CRP measure to predict risk for recurrent stroke, but the CRP measure alone may also be useful for such a prediction.
“Getting a CRP measure on someone is really simple,” he said in the release. “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.”
The researchers also found that fibrinogen levels were associated with recurrent stroke in the VISP cohort, but they found no genome-wide association between any fibrinogen-associated variant and recurrent stroke. – by Erik Swain
Disclosure: The researchers report no relevant financial disclosures.
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