# Predictive value of serum inflammatory factors high-sensitivity C-reactive protein combined with high level of lipoprotein-associated phospholipase A2 for the onset of ischemic stroke

## TL;DR

This study shows that combining two blood markers improves predicting the risk of ischemic stroke by assessing inflammation and plaque instability.

## Contribution

The study demonstrates that combining hs-CRP and Lp-PLA2 improves ischemic stroke prediction compared to using either marker alone.

## Key findings

- Levels of hs-CRP and Lp-PLA2 were significantly higher in ischemic stroke patients compared to healthy controls.
- Combining hs-CRP and Lp-PLA2 improved predictive accuracy (AUC=0.786) compared to using either marker alone.
- The interaction between hs-CRP and Lp-PLA2 may worsen vascular inflammation and plaque instability, contributing to stroke onset.

## Abstract

The aim of this study was to carried out an exploration of the predictive value of serum high-sensitivity C-reactive protein (hs-CRP) plus high levels of lipoprotein-associated phospholipase A2 (Lp-PLA2) for the onset of ischemic stroke (IS). This study extends the understanding of their interplay by highlighting their mechanistic contributions to vascular inflammation and plaque instability, factors crucial in IS onset.

526 IS patients were selected as the experimental group (EG). During the same period, 463 healthy individuals served as the control group (CG). The levels of Lp-PLA2, myeloperoxidase (MPO), total cholesterol (CHO), low-density lipoprotein cholesterol (LDL-C), triglyceride (TG), hs-CRP, and serum ferritin (SF) in the serum of subjects were compared. The predictive efficacy of combination of two for the onset of IS was assessed.

The levels of Lp-PLA2, MPO, CHO, LDL, TG, hs-CRP, and SF in patients with IS were all markedly higher as against the CG (P<0.05). Multivariate Logistic regression analysis (MLRA) suggested that both hs-CRP and Lp-PLA2 were independently associated with the risk of IS (OR=1.334, 95% CI=1.713~1.954; 1.251, 1.011~1.921). The ROC curve analysis revealed that the predictive efficacy for IS of hs-CRP in combination with Lp-PLA2 (area under the ROC curve (AUC)=0.786) was markedly better as against hs-CRP alone (0.713) or Lp-PLA2 alone (0.698) (P<0.05). Mechanistically, their interaction may exacerbate vascular inflammation, promoting plaque instability, a crucial process in IS development.

This study reinforces that the combined detection of hs-CRP and Lp-PLA2 significantly improves IS risk prediction by offering a more comprehensive assessment of inflammatory and atherosclerotic status. Their interplay suggests potential therapeutic targets for preventing IS.