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FUNDAMENTO: O Acidente Vascular Cerebral é uma das principais causas de morte no Brasil. O conhecimento sobre a etiologia do AVC é fundamental para uma adequada abordagem dessa doença. OBJETIVO: Avaliar se existe relação entre o subtipo de AVC isquêmico com o prognóstico dele e os fatores de risco. MÉTODOS: Foram avaliados 86 casos de AVC isquêmico no Ambulatório de Neurologia do Hospital Universitário da cidade de Canoas-RS, no período de outubro de 2018 a novembro de 2019. Foi analisada a relação do prognóstico (mRankinS) com fatores de risco de AVC e TOAST. RESULTADOS: Avaliando 86 pacientes com 60.5 (±10.1) anos (40 homens), identificamos que oclusão de pequenos vasos apresentou melhor prognóstico (p: 0.031) e cardioembolia um pior prognóstico de acordo com mRankinS (p< 0.001). Diabetes mellitus também apresentou um pior prognóstico (p: 0.021). CONCLUSÃO: Pacientes com AVC isquêmico secundário a oclusão de pequenos vasos apresentam melhor prognóstico de acordo com mRs. Mecanismos cardioembólicos e a presença de DM estão associados com o pior prognóstico neurológico
BACKGROUND: Stroke is one of the main causes of death in Brazil. Knowledge about the etiology of stroke is essential for an adequate approach to this disease. OBJECTIVE: To assess whether there is a relationship between the ischemic stroke subtype and its prognosis and risk factors. METHODS: 86 cases of ischemic stroke were evaluated at the Neurology Outpatient Clinic of the University Hospital in the city of Canoas-RS, from October 2018 to November 2019. The relationship between prognosis (mRankinS) and stroke risk factors and TOAST. RESULTS: Evaluating 86 patients aged 60.5 (±10.1) years (40 men), we identified that small vessel occlusion had a better prognosis (p: 0.031) and cardioembolism a worse prognosis according to mRankinS (p <0.001). Diabetes mellitus also had a worse prognosis (p: 0.021). CONCLUSION: Patients with secondary ischemic stroke small vessel occlusion have a better prognosis according to mRs. Cardioembolic mechanisms and the presence of DM are associated with a worse neurological prognosis
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Humans , Male , Female , Middle Aged , Ischemic Stroke/diagnosis , Ischemic Stroke/physiopathology , Prognosis , Risk Factors , Diabetes Mellitus , Ischemic Stroke/therapy , HypertensionABSTRACT
To explore the clinical significance of C1q tumor necrosis factor-related protein-9 (CTRP9) in patients with cerebral infarction.Our data showed that the serum CTRP9 was significantly lower than that of control group,especially in patients with large artery atherosclerotic cerebral infarction.CTRP9 was first decreased and even lower from day 4 to day 10,then gradually elevated.Logistic regression analysis suggested that high CTRP9 level was a protective factor for cerebral infarction.Thus,CTRP9 could be a factor for further classification of cerebral infarction and provides a potential option for disease prevention and treatment.
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Objective To determine the value of using B-type natriuretic peptide (BNP) and D-dimer in preliminary recognition of cardioembolic stroke patients.Methods A mutilple-center study was conducted in Foshan Hospital of traditional Chinese Medicine (TCM) and its affiliated hospitals from July 2015 to July 2016.In the emergency departments (EDs),emergency physicians prospectively assessed consecutive adult patients with acute cardioembolic stroke and measured plasma BNP by POCT platform on admission,then followed up.Stroke neurologists evaluated patients' functional outcome at hospital discharge and also made discharge diagnosis and stroke etiologic subtypes according to the TOAST criteria.Results In this study,290 acute ischemic stroke patients met the study criteria [mean age (68.41 ± 12.06) years;53.8％ female].Of the enrolled patients,28.3％ were diagnosed with LAA at discharge,17.9％ with CE,42.8％ with SAO,11.0％ with SOE or SUE.And the mean BNP concentration was significantly higher in the CE group than that in other three subtypes (P ＜ 0.001).After adjustment for multiple clinical predictors like gender,age,coronary artery disease,atrial fibrillation and renal function,BNP and D-dimer were associated with CE [BNP OR:1.044 (95％ CI 1.025,1.064),P ＜ 0.001;D-dimer OR:1.511(95％ CI 1.020,2.238),P =0.039,respectively].Conclusion Through POCT technique in the EDs,cardioembolic stroke patients can be differentiated from other TOAST subtypes.BNP with/without D-dimer has good but different corresponding diagnostic performance in preliminary recognition of cardioembolic stroke patients.
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Objective To explore the risk factors of youth cerebral infarction and its correlation with clinical TOAST types.Methods 82 young patients with acute cerebral infarction(aged from 18 to 45 years old)were select-ed.The risk factors for youth cerebral infarction patients,and the proportion of TOAST subtype and related risk factors were analyzed.Results Risk factors for youth cerebral infarction were as follows:hyperlipidemia (χ2 =48.703,P <0.05),hypertension (χ2 =40.829,P <0.05),carotid sclerosis (χ2 =46.217,P <0.05),hyperhomocysteinemia (χ2 =40.255,P <0.05),smoking history (χ2 =7.853,P <0.05),diabetes (χ2 =18.256,P <0.05)and family history (χ2 =5.944,P <0.05),heart disease (χ2 =5.754,P <0.05).The proportion of their TOAST subtypes were as following:small artery occlusion lacunar(SAD)(39.0%),large artery atherosclerosis(LAA)(24.4%),stroke of other undetemined etiology(SUE)(17.0%),and acute stroke of other detemined etiology(SOE)(12.2%),cardio-embolism(CE)type(7.3%).Major risk factors for LAA subtype included hyperlipidemia,hypertension and carotid atherosclerosis;Major risk factor for SUE subtype was hyperhomocysteinemia;Major risk factors for SOE included hypertension,diabetes.Major risk factor for CE subtype was heart disease.Conclusion The highest proportion of TOAST types in youth cerebral infarction group is small artery occlusion lacunar.Major risk factors for this group of youth cerebral infarction are as follows:hypertension,carotid atherosclerosis,heart disease,diabetes,hyperhomocys-teinemia,obesity,smoking and family history,and these risk factors should be actively intervened.
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Objective To analyze the mechanism of acute ischemic stroke in cancer patients. Methods The clinical TOAST type, laboratory examinations results, imaging examination results and pathology reports of the 96 patients with cancer and acute cerebral infarction were collected. Results According to TOAST mechanism, the main subtype was undetermined causes (41.67%, 40/96). Lung cancer took largest proportion (39.58%, 38/96). In the group of undetermined causes, adenocarcinoma was more common type than squamous. The imaging examination results could be classified into large artery type, large artery and small artery in same basin and multiple small arterys in different basins. We found the main type was multiple small arterys in different basins (52.50%, 21/40). The lever of D-dimer was high in our patients, especially in undetermined causes (P < 0.01). Conclusions Tumor-related acute cerebral infarction has its own uinque mechanism. Tumor is one kind of systemic diseases, which can promote thrombosis through increasing the lever of D-dimer. The cancer-related mechanism is the main mechanism underlying cancer- related stroke, and may become one of the most important mechanismsn in the pathogenesis of stroke in the near future.
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Background Stroke in young person is less frequent than in older populations but has a major impact on the productive individuals and society. Objective To determining risk factors and etiological subtypes of cerebral infarctions in patients of young (20-49 years) age who were admitted to the First Central hospital in Ulaanbaatar, Mongolia. Methods This paper is based on a review of hospital-based studies of patients with cerebral infarction in age range 20-49 years which was conducted from 2009 to 2013. Data regarding onset of cerebral infarction, clinical manifestations, diagnostic test results of patients were examined during their hospital treatment and modified Rankin Scale scores at discharge. Subtyping of cerebral infarction was conducted in accordance with the Trial of Org 10172 in Acute Stroke Treatment (TOAST) criteria. Results Out of total number of 1289 patients admitted for cerebral infarctions, 259 (20.1%) were in the 20-49 year age range and the male-to-female ratio was 1.3:1. The most common conventional risk factors were hypertension (39.8%), premature atherosclerosis (20.8%) and dyslipidemia (17.8%). From the rare specific risk factors in young patients with cerebral infarction were migraine with aura in combination with other risk factors and hypotension, and cerebral vasculopathies. The majority of subtype of cerebral infarction was undetermined (34.7%), followed by other determined etiologies (19.7%). Among the category of undetermined etiology, incomplete evaluation (71.1%) was predominant. Most of the patients demonstrated good functional outcomes, at the time of hospital discharge, 86.9% patients had Rankin Scale scores in the range of 0-2 points. Conclusions Young adults with cerebral infarction account for 20.1% of all stroke patients in tertiary referral hospital in Ulaanbaatar. Risk factors, including conventional and specific causes in combination relatively prevalent in young adults, and a high rate of the patients are categorized under conventional, other determined and undetermined etiologies. Cerebral infarction in the young requires a different approach to investigation and management than ischemic stroke in the elderly given differences in the relative frequencies of possible underlying causes. The results show the needs for persistent management of conventional risk factors and properly patient investigation to determine etiology of cerebral infarction in young patients in Mongolia.
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BACKGROUND AND PURPOSE: Stroke in young adults has a special significance in developing countries, as it affects the most economically productive group of the society. We identified the risk factors and etiologies of young patients who suffered ischemic strokes and were admitted to a tertiary referral hospital in North India. METHODS: A retrospective review of case records from patients with ischemic stroke in the age range of 18-45 years was conducted from 2005 to 2010. Data regarding patients' clinical profiles, medical histories, diagnostic test results, and modified Rankin Scale scores at hospital discharge were examined. Stroke subtyping was conducted in accordance with the Trial of Org 10172 in Acute Stroke Treatment (TOAST) criteria. RESULTS: Of the 2,634 patients admitted for ischemic stroke, 440 (16.7%) were in the 18-45 year age range and the majority (83.4%) were male. The most common risk factors were hypertension (34.4%) and dyslipidemia (26.5%). The most common subtype of stroke was undetermined (57%), followed by other determined causes (17.3%). Among the category of undetermined etiology, incomplete evaluation was the most common. Most of the patients demonstrated good functional outcomes. CONCLUSIONS: Young adults account for 16.7% of all stroke patients in North India. Risk factors are relatively prevalent, and a high proportion of the patients are categorized under undetermined and other determined causes. The results highlight the needs for aggressive management of traditional risk factors and extensive patient work-ups to identify stroke etiology in India.
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Humans , Male , Young Adult , Developing Countries , Diagnostic Tests, Routine , Dyslipidemias , Hypertension , India , Retrospective Studies , Risk Factors , Stroke , Tertiary Care CentersABSTRACT
Objective The relationship between hypertension ( HTN) and ischemic stroke recurrence is unclear , but there may be different effects of HTN on the risk of recurrence .This study aims to explore whether HTN contributes differently to the recur-rence among subtypes of ischemic stroke ( IS) . Methods We eventually enrolled 1114 patients with ischemic stroke from Jul 2008 to Dec 2012 registered in Nanjing Stroke Registry Program (NSRP) in this study.All the patients were classified according to Trial of Org 10172 in Acute Stroke Treatment (TOAST) criteria: 315 (28.3%) patiwnts were classified as Large-artery atheroselerosis (LAA), 212 (19.0%) as cardioembolism (CE), 266 (23.9%) as small-artery occlusion (SAO), and 321 (28.8%) as other de-termined and undetermined etiologies ( Other) .The association between HTN and stroke recurrence in patients with different IS sub-types was analyzed using multivariate Cox regression analysis . Results The average follow-up duration was (19.4 ±10.3) months. Of 1114 patients with IS, 158 (14.2%) patients experienced a recurrent stroke .Patients with HTN had a significantly higher stroke recurrence rate than those without (16.5%vs 10.5%, P<0.05).Multivariate Cox regression analysis indicated that HTN increased the risk of ischemic stroke recurrence (HR=1.722, 95%CI:1.181-2.512, P=0.005).After stratification by TOAST subtypes, analysis revealed an association between HTN and stroke recurrence in LAA( HR=3 .767, 95%CI:1.866-7.585, P=0.001) and SAO (HR=3.530, 95%CI:1.156-12.740, P=0.028), but not in the other subtypes (CE: HR=0.773, 95%CI:0.370-1.615, P=0.493;Other:HR=1.498, 95%CI:0.590-3.807, P=0.395). Conclusion HTN is an independent risk factor for recurrent ischemic stroke and is related to the recurrent ischemic stroke in patients with large-artery and small-vessel disease .
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Objective: To study the correlation between the serum chemokine CXC Ligand 16 (CXCL16) levels or the CXCL16 gene rs3744700 polymorphisms and TOAST subtypes in patients with acute cerebral infarction. Methods: A total of 248 patients with atherosclerotic cerebral infarction within 7 days after symptom onset were selected, among them 149 patients were in a large artery atherosclerotic (LAA) cerebral infarction group, and 99 patients were in a small arterial occlusive (SAO) cerebral infarction group. The polymerase chain reaction (PCR) and gene sequencing were used to detect the genotypes. An enzyme-linked immunosorbent assay was used to detect the serum CXCL16 levels. Results: Circled digit oneSerum CXCL16 level in the LAA cerebral infarction group was 2.5 ± 0.3 μm/L and in the SAO cerebral infarction group were 2.3 ± 0.6 μg/L (P<0.01). Circled digit twoAmong the 149 patients in the LAA cerebral infarction group, the GG genotype frequency at polymorphic loci of CXCL16 gene rs3744700 was 91.9% (137/149) and the G allele frequency was 96.0% (286/298). They were higher than 81.8% and 89.9% in the SAO cerebral infarction group. There were significant differences (P < 0.05). Circled digit threeThe serum CXCL16 level in patients with CG genotype was 2.5 ± 0.3 μg/L in the LAA cerebral infarction group, ant it was higher than 2.1 ± 0.3 μg/L in patients with GT + TT genotype; the serum CXCL16 level in patients with CG genotype was 2.4 ± 0.6 μg/L in the SAO cerebral infarction group, and it was higher than 2.1 ± 0.3 μg/L in patients with GT + TT 2 genotype (all P < 0.01). Among the patients with GG genotype, the serum CXCL16 level in the LAA cerebral infarction group was higher than that in the SAO cerebral infarction group (P = 0.01); there was no significant difference in patients with GT + TT genotype between both groups. Circled digit fourMultivariate Logistic regression analysis showed that the serum CXCL16 level (OR =0.37, 95% CI 0.19 -0.70) and the GG genotype at polymorphic loci of CXCL16 gene rs3744700 (OR =2.57, 95% CI 1.23 -5.36) were the independent risk factors for affecting LAA cerebral infarction. Conclusion: In the TOAST subtypes, the correlation of serum CXCL16 level and the GG genotype at polymorphic loci of CXCL16 gene rs3744700 and LAA cerebral infarction are higher than SAO cerebral infarction.
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BACKGROUND: 5-lipoxygenase protein (ALOX5AP) has been recognized as a susceptibility gene for stroke and coronary artery diseases. The present study was to explore the role of this gene in the eastern Chinese patients with ischemic stroke.METHODS: Using a case-control design, we studied 658 patients with ischemic stroke and 704 unrelated population-based controls who were age- and sex-matched. The 658 patients were classified by the Trial of Org 10172 in Acute Stroke Treatment (TOAST). Two single-nucleotide polymorphisms (SNPs) covering ALOX5AP were genotyped.RESULTS: The genotype frequencies of TG of the SNPs rs17222919 located in the promoter of the ALOX5AP gene were significantly higher in patients with ischemic stroke than in controls (OR*=1.34, 95％CI*=1.02-1.75), especially in patients with ischemic stroke caused by small-artery occlusion (SAO) (OR*=1.40, 95％CI*=1.02-1.93). Meanwhile, the genotype frequencies of TG and TG/GG were higher in female patients than in the controls. After specification, the genotype frequencies of TG and TG/GG were higher in the patients than in controls with hypertension. The genotype frequencies of AG and AG/GG of the SNPs rs9579646 located in the intron of the ALOX5AP gene were higher in the controls than in the patients. After specification, the genotype frequencies of TG were higher in the controls than patients without hypertension.CONCLUSION: The present study suggests that sequence variants in the ALOX5AP gene are significantly associated with ischemic stroke.
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ObjectiveTo analyze the distribution of cerebral ischemic stroke by TOAST subtype in different gender and provide basis for prevention. MethodsAll of 463 patients with cerebral ischemic stroke from October 2007 October 2009 were involved in this study. Two hundred and seventy-nine patients were male (male group),and 184 patients were female (female group). The distribution of TOAST subtype was analyzed between the two groups. ResultsAccording to TOAST subtype, large artery atherosclerosis (LAA), small artery obstructive (SAO), cardiogenic embolism(CE),stoke of other etiology(SOE) and stoke of undetermined etiology(SUE) subtype was 54 cases( 19.4％ ,54/279), 95 cases(34.1％ ,95/279),33 cases( 11.8％ ,33/279), 9 cases(3.2％ ,9/279) and 88 cases(31.5％ ,88/279) in male group;22 cases ( 12.0％ ,22/184),66 cases (35.9％ ,66/184),35 cases ( 19.0％ ,35/184),6 cases (3.3％ ,6/184) and 55 cases (29.9％ ,55/184) in female group. The percentage of LAA was higher and the percentage of CE was lower in male group than in male group that in female group (P ＜ 0.05 ). ConclusionThedistribution of cerebral ischemic stroke in different gender by TOAST subtype exists difference.
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Objective To determine and compare the levels of serum matrix metalloproteinase (MMP)-2 and MMP-9 in acute stage of cerebral infarction and the relationship and prognosis between them and the classification of TOAST. Methods The levels of MMP-2 and MMP-9 were detected by ELISA in 60 cerebral infarction patients(CI group)while 30 healthy donors were served as control group (NC group).Results The level of MMP-2 in CI group was significantly lower than that in NC group (P＜0.01) and the level of MMP-9 was significantly higher than that in NC group (P＜0.01).Compared with lacunar infarction (LI) group,the level of MMP-9 was significantly higher in cardiogenic cerebral embolism group(CCE group) and large artery arteriosclerosis cerebral infarction group (LAA group);The serum level of MMP-9 was related to NIHSS.The serum level of MMP-9 in good prognosis patients was significantly lower than that in poor prognosis patients (P＜0.01).Conclusions The serum level of MMP-9 is increased after cerebral infarction.The serum level of MMP-9 in the CCE group and LAA group is significantly higher than that in LI group.The level of MMP-9 is a reliable parameter in evaluating the disabilities in cerebral infarction.The level of serum MMP-9 within 24 hours of onset can predict the prognosis of cerebral infarction independently.
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Objective To investigate the pattern of fluctuations and clinical significance of fasting serum insulin(FINS) and C-peptide(CP) levels in patients with different subtypes of acute cerebral infarct(ACI) and its relationship with serum lipid. Methods FINS and CP were measured in 152 ACI patients by chemiluminescent immunoassay. All ACI patients were classified into 5 major ischemic stroke subtypes according to the trial of org10172 in acute stroke treatment(TOAST) criteria. And then the relationship between FINS and CP level and serum lipid in different TOAST subtypes were analysed. Results The percentage of each ischemic stroke TOAST subtype was as follow: stroke of undetermined etiology 40.13%, small-vessel occlusion 34.21%, cardioembolism 5.26%, large-artery atherosclerosis 15.79%, and stroke of other determined etiology 4.61%. Among 5 major stroke subtypes, large-artery atherosclerosis patients had the highest levels of FINS and CP. The levels of FINS and CP in small-vessel occlusion were (8.237?5.144) ?U/ml and (1.761?0.975)ng/ml,respectively. Stroke of other determined etiology subtypes were associated with the lowest levels of FINS and CP. Apparently, other factors, such as TC, TG, LDL, SBP, DBP, age and HDL, could also affect the levels of FINS and CP in serum. Conlusions Levels of FINS and CP varied in different subtypes of ACI. There was a significant correlation among insulin resistance, hyperinsulinemia(HIS) and lipid metabolic abnormality in ACI.
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BACKGROUND AND PURPOSE: There is no clear description about the patterns of each mechanism of striatocapsular infarctions. The aims of our study were to elucidate differences in the distributions of lesions of acute middle cerebral artery (MCA) infarctions involving the striatocapsular region and to compare those following embolic striatocapsular infarctions with those originating from MCA disease. METHODS: We prospectively enrolled patients with acute infarcts located in the lenticulostriate artery territory that were not lacunar infarcts. Brain coronal diffusion-weighted imaging (DWI) was obtained and magnetic resonance angiography (MRA) was carried out to evaluate the distribution of infarct lesions and MCA stenosis in all patients. The types of infarct distribution were divided into three categories: (1) dominant in the distal territory (DD), (2) distributed equally between the distal and proximal territories (DE), and (3) dominant in the proximal territory. We performed tests for embolic sources (transthoracic echocardiography, transesophageal echocardiography, Holter monitoring, and contrast-enhanced MRA including the aortic arch) in most patients. Stroke mechanisms were classified into stroke from proximal embolism, MCA disease, and stroke of undetermined etiology. RESULTS: A total of 47 patients (28 men and 19 women; mean age, 62 years) were recruited. A proximal embolic source was significantly more prevalent in patients with a DE lesion than in those with a DD lesion. The most common proximal embolic source was of cardiac origin. In contrast, symptomatic MCA stenoses were more common in patients with a DD lesion than in those with a DE lesion. CONCLUSIONS: These results suggest that the dominant area of striatocapsular infarction on coronal DWI is an important clue for stroke etiology. Coronal DWI could therefore be helpful to determining the mechanisms in patients with striatocapsular infarctions that are currently described as having an "undetermined etiology" according to the Trial of Org 10172 in Acute Stroke Treatment classification.
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Female , Humans , Male , Arteries , Brain , Classification , Constriction, Pathologic , Echocardiography , Echocardiography, Transesophageal , Electrocardiography, Ambulatory , Embolism , Infarction , Magnetic Resonance Angiography , Middle Cerebral Artery , Prospective Studies , Stroke , Stroke, LacunarABSTRACT
PURPOSE: This paper evaluate and classified the risk factors that could possibly cause ischemic stroke in children, and investigate whether TOAST classification could be applied to the ischemic stroke in children. METHODS: From March 1995 to February 2002, we retrospectively reviewed the medical record of 87 patients under the age 16 who had been registered to the Ajou Stroke Registry. We evaluated the risk factors of ischemic stroke according to the Ajou Stroke Registry Protocol, and classified the risk factors into 6 main subgroups. In addition, the risk factors were investigated according to the age distribution. TOAST classification had been applied to children with ischemic stroke. RESULTS: There was 64 ischemic stroke(73.6%) and 23 hemorrhagic stroke(26.4%) among the 87 patients. In children with ischemic stroke, there was three major peak age; 13 patients younger than 1 year old(15.3%), 26 patients in age 5 to 8 years old(40.6 %), 22 patients in 9 to 12 years old(34.3%). Vasculopathy(48.6%) was the most common risk factor of the ischemic stroke in this study. Other important risk factors in order of frequency were hypertensive encephalopathy(12.5%), infectious disease(7.8%), metabolic disease(7.8%), and hematologic disease(6.2%). Moyamoya disease was the most common cause of ischemic stroke due to vasculopathy. If we analyze the risk factors according to the age at the presentation of ischemic stroke, 90% of the ischemic stroke due to vasculopathy had been developed after 5 years of age. However, ischemic stroke due to infectious disease had been developed less than 4 years of age. Major stroke was the most common subtype of the ischemic stroke in children, but TIA had been found in 80% of the patients with ischemic stroke due to moyamoya disease. TOAST classification determined the subtype of the ischemic stroke only in 2 children. Risk factors of ischemic stroke in the remained 62 patients were extremely variable, and could not be applicable to the TOAST classification. CONCLUSION: Risk factor of ischemic stroke were found in the 90% of patients. Although risk factors of ischemic stroke were extremely variable in children, cerebral vasculopathy including moyamoya disease was the most common. However, inherited metabolic disorder, coagulopathy, and hypertensive encephalopathy were also relatively common risk factors of ischemic stroke especially in children older than 5 years old. Therefore, we must extensively evaluate all the possible risk factors of ischemic stroke in children. TOAST classification could not be applicable in children because the risk factors of ischemic stroke were extremely variable.
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Child , Child, Preschool , Humans , Age Distribution , Classification , Communicable Diseases , Hypertensive Encephalopathy , Medical Records , Moyamoya Disease , Retrospective Studies , Risk Factors , StrokeABSTRACT
Objective To study the correlation between 2007 modified TOAST classification and OCSP classification.Methods Totally 177 patients were classified based on the 2007 modified TOAST and OCSP criteria.Analyze whether there was any correlation between the two typing.Results TACI and LACI had significant deviation on distribution of modified TOAST subtype(P
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Objective To investigate the changes of the serum high sensitive C-reactive protein (hs-CRP)level in patients with acute cerebral infarction (ACI) and study the relationship between hs-CRP level and ischemic stroke subtypes according to the trail of org10172 in acute stroke treatment (TOAST) criteria.Methods The serum hs-CRP was measured in 152 ACI patients by immunonephelometrical method. All ACI patients were classified into 5 major ischemic stroke subtypes based on TOAST criteria. And then the relationship between hs-CRP level and their TOAST subtypes were analysed.Results The percentage of each ischemic stroke TOAST subtypes of 152 patients was as following: stroke of undetermined etiology 41.45%, small-vessel occlusion 34.87%, cardioembolism 5.26%, large-artery atherosclerosis 15.79%, and stroke of other determined etiology 2.6%. Among 5 ischemic stroke subtypes, cardioembolism patients were related to the highest positive rate of hs-CRP(87.50%) and the highest hs-CRP level [(11.60?7.85)mg/L]. The hs-CRP level in large-artery atherosclerosis or stroke of other determined etiology were (10.77?4.27) mg/L or (6.45?3.25) mg/L respectively, Stroke of undetermined etiology and small-vessel occlusion subtypes were associated with the lowest positive rate of hs-CRP(38.10%, 37.74%) and the lowest hs-CRP level [(4.09?5.65)mg/L,(3.99?0.56)mg/L]. Apparently, other factors, such as age, systolic blood pressure, cholesterol, triglyeride, fasting blood sugar and fibrinogen, could also affect the hs-CRP level in serum(r=0.1640、0.2489、0.2066、0.1866、0.3029、0.2224,all P