Evaluation of routine laboratory markers as short-term outcome indicators in patients with acute ischemic stroke

Abstract

Abstract Introduction: Stroke is a disease with high mortality and morbidity. Currently, there are no specific laboratory markers that can replace or improve clinical and radiological diagnosis and prognosis. We evaluated the role of C-reactive protein (CRP), fibrinogen and D-dimer in predicting short-term outcomes in acute ischemic stroke. Methods: We included 118 acute ischemic stroke patients, admitted within 24 h of onset, mean age 72.73±10.08 years. The severity of the stroke was assessed by the National Institutes of Health Stroke Scale (NIHSS), and for poor outcome (PO) we accepted a severe functional deficit at the end of the hospital stay with NIHSS ≥15, and for good outcome (GO) – NIHSS ≤ 14. In all patients, we monitored the dynamics of CRP, fibrinogen and D-dimer and evaluated their predictive value regarding to the PO and GO of the stroke. Results: D-dimer had the strongest poor predictive value at admission (p<0.001). Six hours after admission, CRP, D-dimer or both were higher in PO patients (p=0.046, p=0.022 and p=0.006, respectively). At the 24.h, only CRP could be used to predict PO (p<0.001). Elevated CRP, D-dimer or both have been determined as strong indicators of PO with 72 hours of admission (p<0.001, p=0.032 and p=0.001, respectively). Fibrinogen levels were higher 72 hours after admission without a significant relationship with the NIHSS. Conclusion: Changes in routine biomarkers CRP and D-dimer, but not fibrinogen, can predict short-term stroke prognosis and may be associated with the risk of early neurological deterioration or death during hospital stay.