FREQUENCY OF RAISED C-REACTIVE PROTEIN IN ACUTE ISCHEMIC STROKE

Abstract

Objective: To find out the frequency of raised C- reactive protein (CRP) levels in patients with first-ever acute ischemic stroke.

Methodology: This hospital based descriptive (case series) study was carried out in Neurology Unit, Lady Reading Hospital, Peshawar, Pakistan from March 2011 to December 2011. A total of 100 patients with first-ever acute ischemic stroke, aged 18 years and above and of either gender, were included by convenient sampling technique. National Institute of Health stroke scale (NIHSS) was measured at the time of admission to assess stroke severity. Within 24 hours of admission high-sensitivity (hs)-CRP levels were measured. Data were analyzed using SPSS version 15.0.

Results: Out of 100 patients, 58(58%) were females and 42 (42%) were males. Mean age was 64.7+14 years. Sixty seven patients (27 males & 40 females) had raised hs-CRP levels. Out of 67 patients with raised hs-CRP, 25 (37.31%) patients had a severe (NIHSS 15-24 ) and 19 (28.36%) patients had a very severe stroke (NIHSS >25). Thirty one (46.27%) patients had hs-CRP level of >3.0 mg/L having a high risk of ischemic stroke while 22/67 (32.8%) with hs- CRP level of 1.0-3.0 mg/L had an average risk of ischemic stroke. Fourteen (20.89%) patients had hs-CRP level of <1.0 mg/L and had low risk of ischemic stroke. Mean serum level of hs- CRP in ischemic stroke patients was 23+11.24 mg/L.

Conclusion: hs-CRP is elevated in a significant number of patients with acute ischemic stroke. An elevated CRP was associated with increased stroke severity.

Key Words: Stroke, Acute Ischemic Stroke, C-reactive Protein, High-sensitivity C-reactive Protein, Inflammatory Markers, National Institute of Health Stroke Scale.