HIGH SENSITIVE C-REACTIVE PROTEIN IN CEREBROVASCULAR ISCHEMIA

BACKGROUND Cerebrovascular ischemia is recognized as a major health problem, which causes significant morbidity and mortality. The main pathophysiology of ischemic stroke is atherosclerosis of cerebral vessels. Hs-CRP is a sensitive marker of inflammation tissue injury in the arterial wall, which contributes to atherosclerosis. In this study, we aim to investigate the association of hs-CRP in patients with ischemic stroke and to correlate hs-CRP levels with possible risk factors of ischemic stroke and to assess the prognostic value of hs-CRP in ischemic stroke. METHODS In the present case control study after meeting inclusion and exclusion criteria, 50 patients with acute ischemic stroke admitted in the medical ward, King George Hospital, during the period between April 2014 and October 2014 and 40 asymptomatic age and sex matched control subjects were included. RESULTS The mean hs-CRP value in cases is 3.78+5.28mg/dl and in controls is 0.425+0.305mg/dl. Mean hs-CRP value is higher (3.78mg/dl) in cases when compared to controls (0.425mg/dl), which is statistically significant. P<0.05. The mean age of cases was 56.82+12.94 years. Out of 50 cases, 39 were male, 11 were female. Out of 40 controls, 30 (75%) were male and 10 (25%) were female. Mean age of controls was 52.75+11.64 years. Out of 50 cases 12 (24%) were diabetics with mean hs-CRP value of 4.125+4.63mg/dl; 38 (76%) were non-diabetics with mean hs-CRP value of 3.668+5.56mg/dl. P=0.417. Out of 50 cases 43 (86%) were hypertensive with mean hs-CRP value of 3.99+5.45, 7 (14%) were non-hypertensives with mean hs-CRP value of 2.45 +/- 1.74mg/dl. P=0.301. Out of 50 cases 20 (40%) were with hyperlipidemia with mean hs-CRP value of 3.12+5.24mg/dl, 30 (60%) were with normal lipid profile with mean hs-CRP value of 4.126+5.44mg/dl. P=0.54. Out of 50 cases 37 (74%) were smokers with mean hs-CRP value of 4.29+5.93mg/dl, 13 (26%) were non-smokers with mean hs-CRP value of 2.315+3.31mg/dl. P=0.61. Out of 50 cases 27 (54%) were alcoholics with mean hs-CRP value of 4.35+6.04mg/dl, 23 (46%) were non-alcoholics with mean hs-CRP value of 2.63 +/- 4.67mg/dl. P=0.74. Out of 50 cases 23 (46%) were admitted with moderate degree of weakness (3-4/5 power) with mean hs-CRP value of 0.66 +/- 0.48mg/dl, improved at the time of discharge (4+/5 to 5/5 power); 19 (38%>) admitted with severe degree of weakness (0-1/5 power) with mean hs-CRP value of 4.28+4.07 without significant improvement in the power at the time of discharge; 8(16%>) with mean hs-CRP value of 10.43+7.74 were expired. CONCLUSION Acute ischemic patients had higher mean hs-CRP values when compared to healthy asymptomatic control subjects P<0.005. There is no statistically significant correlation between mean hs-CRP values and other vascular risk factors like Diabetes mellitus, Hypertension, Hyperlipidemia, Smoking and Alcohol P>0.05. Higher mean hs-CRP values were associated with poor outcome after acute ischemic stroke. P<0.001.