Clinical application of C-reactive protein in stroke prevention: bright and dark sides of the moon

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In different study populations, several studies have shown that modest C-reactive protein elevation, in the range of apparently healthy individuals, is a strong predictor of future vascular events. Willcox and colleagues summarize the epidemiological and clinical observations that have led to the enthusiastic suggestion that determination of serum C-reactive protein levels could also be used as an adjunct for risk assessment in primary and secondary prevention of cerebrovascular disease. Currently, high-sensitivity C-reactive protein assays as a screening test to ascertain individuals at risk of cerebrovascular disease does not provide an accurate determination of the risk of stroke likelihood, and adequate evidence that early detection improves health outcomes and that an early intervention is likely to have a beneficial impact. High-sensitivity C-reactive protein assays as a screening test, only provide inadequate evidence to be considered as an effective cerebrovascular screening test, especially in the elderly.

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