High sensitivity C-reactive protein as a prognostic marker in ischaemic and haemorrhagic stroke

Abstract

Background: Stroke is the leading cause of death worldwide and one of the main causes of long-term disability. Many patients with elevated CRP levels within 72 hours of stroke have an increased risk of death. However, vascular inflammation is more related to high-sensitivity CRP (hsCRP).There is a distinct possibility that elevated hsCRP may be a direct response to the extent of cerebral tissue injury. The aim of this study was to compare the high sensitivity C-reactive protein (hsCRP) level in patients of stroke and assess its utility in predicting the functional outcome. Methods: A prospective study of 50 patients presenting with a history of focal neurological deficit of acute onset in the form of hemiparesis/hemianaesthesia and having evidence of presence of infarct/haemorrhage in CT/MRI scan of brain and 50 age and sex matched healthy controls was done. In all patients hsCRP levels were measured within 24 hours of presentation. Admission hsCRP levels were then compared to the scandinavian stroke scale scores. Results: Mean hsCRP levels were significantly higher in patients with stroke than controls. Patients with a good long term outcome had a statistically significant lower hsCRP levels. 8 patients died during follow/hospitalisation. They had higher hsCRP levels than patients who survived. hsCRP levels and scandinavian score showed a significant correlation both with ischemic and haemorrhagic stroke. Conclusion: hsCRP can be used as a marker for prognosis in cases with stroke. hsCRP levels are higher in ischemic stroke than in haemorrhagic stroke.