C-reactive protein in acute ischemic stroke: correlation with the risk factors and stroke outcome

ABSTRACT

The aim of our study was to evaluate serum C reactive protein [CRP] levels in acute ischemic stroke and to correlate the values with stroke severity, outcome and other generally known risk factors. We studied 100 patients who were admitted with acute ischemic stroke. All patients underwent a clinical evaluation, laboratory investigations and radiologic examination in the first 12 hours of acute ischemic stroke. Neurological status was evaluated by modified Rankin Scale [m-RS] on admission and after one month. CRP was abnormally increased in 35% of our study patients. Elevated CRP levels were significantly associated with severe disability on admission and were also associated with large cortical and subcortical infarcts. We found a significant correlation between CRP, WBC as well as fibrinogen levels and stroke outcome as measured by m-RS after one month [P <0.0001]. Carotid atherosclerosis was significantly frequent in patients with elevated CRP when compared with those with normal CRP [P <0.0001]. The mean systolic or diastolic blood pressure irrespective to the history of arterial hypertension was significantly higher in patients with increased CRP levels when compared with those with normal CRP [P <0.0001]. We conclude that elevated CRP levels are associated with severe functional disability, poor outcome and predict a larger infarct size. Elevated CRP is a significant index for carotid atherosclerosis and may be one of underlying processes related to the inflammatory response after acute ischemic stroke