A study on High Sensitivity C – Reactive Protein as a determinant in the outcome of acute ischemic stroke

Background: In recent years, there has been increasing evidence which shows strong links between inflammation and the pathogenesis of atherothrombotic stroke. Acute phase proteins have been implicated to play roles both during acute and chronic inflammatory processes in different diseases including ischemic stroke. Even low grade infections may cause elevation of various acute phase reactants which may partly be responsible for the inflammatory process observed in atherosclerotic lesions, which may in turn relate to occurrence of ischemic symptoms. Aim of the study: To evaluate the predictive value of hs-CRP in relation to the ultimate functional outcome in first ever ischemic stroke after 4 weeks. Materials and methods: A total of 50 patients who presented with acute ischemic stroke confirmed by CT scan were enrolled into the study. As soon as the patients were admitted within 48 hours of onset of stroke, serum samples were taken for hs-CRP estimation. The serum hs-CRP level was correlated with the functional recovery of patients after 4 weeks using the GOS. Patients with score of 4 and 5 were included in the good outcome and patients with score of 1, 2, 3 were included in the poor outcome category. Results: Mean age of individuals in this study was 60.32 years ± 7.44. Male patients were 48% (24) and female patients were 52% (26). Patients with GOS score of 4 or 5, i.e. those with favorable outcome (34%) 30% had CRP < 10.1 mg/L and 4% had CRP > 10.1 mg/L. All the remaining 66% cases with GOS score of 1, 2 or 3, (i.e. unfavorable outcome) had hs-CRP > 10.1 mg/L. Conclusion: Patients with elevated hs-CRP had a poorer outcome when compared to patients with lower levels of CRP, four weeks after the onset of ischemic stroke.