Evaluation of the Role of Plasma High Sensitivity C-reactive Protein Levels as a Prognostic and Diagnostic Marker in Acute Ischemic Stroke

Introduction: Cerebrovascular disease is the second most common cause of death worldwide. Male gender, older age, smoking, hypertension, diabetes, and hypercholesterolemia are the well-known risk factors for carotid disease as well as for stroke. An increasing body of evidence has linked inflammation with the pathogenesis of atherothrombotic stroke. C-reactive protein (CRP), one of the acute phase reactants, is an indicator of the underlying systemic inflammation and a novel plasma marker of atherothrombotic disease. Hence, the measurement of plasma high sensitivity CRP (hs-CRP) levels can be useful in stroke patients. Materials and Methods: 60 patients with either hypertension or diabetes or both or none without thrombolysis with the first ever acute ischemic stroke patients were examined with the exclusion from the exclusion criteria. Plasma hs-CRP level was determined within 72 h of onset of symptoms in all computed tomography-confirmed ischemic stroke patients. This clinical study was performed during July 2013 to July 2014. hs-CRP was randomly measured in 60 ageand sex-matched individuals admitted in other wards of the hospital matched in all possible criteria expect the disease under study as a control group. Results: The hs-CRP concentration was significantly elevated in acute ischemic stroke as compared to control group and it was more between 51 and 70 years of age group and almost equal in both genders. Only 54 of the 60 ischemic strokes patients had hs-CRP value >3 mg/L and only six patients had <3 mg/L (P < 0.001), which is statistically significant. Only 7 of the 60 control group patients had hs-CRP >3 mg/L, which is insignificant. Conclusion: The hs-CRP level is significantly higher in ischemic strokes and by its elevation within 72 h of symptom onset was a bad prognostic indicator. Elevated hs-CRP values were a risk factor in association with other risk factors such as diabetes/ hypertension.