ArticleBMC neurology2026
Cut-off values of serum homocysteine and high-sensitivity CRP for predicting early neurological improvement after intravenous thrombolysis.
Article in BMC neurology, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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Abstract
backgroundWe aimed to determine cut-off values of factors affecting early neurological improvement in patients after recombinant tissue plasminogen activator therapy for acute ischemic stroke.
methodsA total of 135 patients with acute ischemic stroke treated with tissue plasminogen activator within 4.5 h of stroke onset were enrolled at a single center. Therapy outcomes were based on early neurological improvement, defined as when the NIHSS score after 24 h of tPA treatment decreased by ≥ 40% from the baseline value. Binary logistic regression analysis was used to identify the factors affecting early neurological improvement.
resultsSixty-nine (51.1%) patients had early neurological improvement. Multivariate analysis showed that younger age, absence of diabetes mellitus, presence of hypertension, lower serum homocysteine (odds ratio, 0.865; 95% confidence interval, 0.787-0.950; P = 0.003) and lower high-sensitivity C-reactive protein (0.345; 0.203-0.586; P < 0.001) levels were significantly associated with a higher probability of early neurological improvement. The cut-off values of serum homocysteine and high-sensitivity C-reactive protein were 11.99umol/L and 1.16mg/L, respectively. If Hcy and hsCRP were combined and used together, it was possible to predict ENI better than when Hcy and hsCRP was used alone. (sensitivity 92.75, specificity 60.61, and optimal cut-off value 23.65) ROC analyses showed modest discrimination for homocysteine (AUC 0.743, 95% CI 0.660-0.814) and hsCRP (AUC 0.747, 95% CI 0.665-0.818), with improved discrimination when both biomarkers were combined (AUC 0.797, 95% CI 0.719-0.861).
conclusionsIn IVT-treated AIS, lower homocysteine and hsCRP were independently associated with early neurological improvement.
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