The serum concentrations of the acute phase proteins, C-reactive protein, serum amyloid A protein, and alpha-1-antichymotrypsin were determined in 50 young and middle aged patients with cerebral infarction and in sex and age matched community controls. Of 46 case control pairs, 11 cases but only one control had raised acute phase protein concentrations simultaneously (p less than 0.01); four case control pairs were excluded because of an infectious complication following infarction and an acute phase response. Seven of the 11 patients (64%) with raised acute phase protein concentrations had a history of bacterial infection in the preceding month but of the remaining 35 patients without raised concentrations only four (11%) had such a history (p less than 0.01). In general, the acute phase response was less pronounced and occurred less often than has been reported in patients after acute myocardial infarction. The results suggest that a positive acute phase response is associated with a preceding bacterial infection or with an infectious complication after cerebral infarction. Measurement of acute phase proteins, therefore, could be used to evaluate the possible role of preceding bacterial infection in the development of cerebral infarction and also in the management of these patients as an early indicator of possible infectious complications.
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