High sensitivity C-reactive protein levels in Acute Ischemic Stroke and subtypes: A study from a tertiary care center
Jaydip Ray Chaudhuri1, Kandadai Rukmini Mridula, Matapathi Umamahesh
1Department of Neurology, Yashoda Hospital, Hyderabad, India.
Insights
High sensitivity C-reactive protein (hsCRP) is a significant independent predictor of acute ischemic stroke in Indian patients. Elevated hsCRP levels were associated with stroke subtypes, including cardioembolic stroke and large artery atherosclerosis.
Area of Science:
- Cardiology
- Neurology
- Biomarkers
Background:
- Stroke is a complex condition with multiple risk factors.
- High sensitivity C-reactive protein (hsCRP) is a known marker for cardiovascular and cerebrovascular diseases.
- Previous research indicates a link between elevated hsCRP and ischemic stroke risk.
Purpose of the Study:
- To investigate the association between high hsCRP levels (> 3 mg/L) and ischemic stroke.
- To examine this association in relation to specific ischemic stroke subtypes.
- To assess the prevalence of high hsCRP in Indian patients diagnosed with ischemic stroke.
Main Methods:
- A case-control study involving 210 acute ischemic stroke patients and 150 controls.
- Serum hsCRP levels were measured upon admission for all participants.
- Stroke patients were recruited within 72 hours of symptom onset at Yashoda Hospital, Hyderabad, India.
Main Results:
- Stroke patients exhibited significantly higher mean hsCRP levels (3.8 ± 2.5) compared to controls (1.8 ± 1.5).
- High hsCRP was more frequent in stroke patients (61.9%) than controls (6.6%).
- Elevated hsCRP was independently associated with acute ischemic stroke (OR 4.5) and specific subtypes like cardioembolic stroke (OR 3.4) and large artery atherosclerosis (OR 2.1).
Conclusions:
- High hsCRP levels are strongly associated with acute ischemic stroke in the Indian population.
- Elevated hsCRP serves as an independent predictor for acute ischemic stroke.
- The association between high hsCRP and ischemic stroke was consistent across all studied subtypes.
Background:
Stroke is a heterogeneous disease with several risk factors. High sensitivity C-reactive protein (hsCRP) is a marker for cardiovascular and cerebrovascular diseases. Recent studies have shown that high hsCRP level is a risk factor for ischemic stroke. The objective of our study was to investigate the association of high hsCRP (> 3 mg/L) levels with ischemic stroke and its subtypes in Indian patients.
Methods:
We recruited 210 consecutive acute stroke patients and 150 age and sex matched controls. Stroke patients were admitted within 72 hours of onset, at Yashoda Hospital, Hyderabad, India. The study period was from January 2011 to December 2012. All patients underwent tests as per standard protocol for stroke workup. Serum hsCRP level was assessed in all stroke patients and controls on the day of admission.
Results:
The mean hsCRP was significantly higher in stroke patients (3.8 ± 2.5) than controls (1.8 ± 1.5) (P < 0.001). High hsCRP had higher frequency in stroke patients 130 (61.9%) compared to controls 10 (6.6%), P < 0.001. High hsCRP level was more prevalent in the stroke subtypes of cardioembolic stroke (83.3%) and large artery atherosclerosis (72%). High hsCRP level was significantly associated with hypercholesterolemia (P = 0.001), age (P = 0.01), and mortality (0.04). After adjustment of regression analysis it was observed that high level hsCRP is independently associated with acute ischemic stroke (Odds 4.5; 95% CI: 2.5-12.2); especially the stroke subtypes of cardioembolic stroke, (odds ratio 3.4, 95% CI: 1.9-10.5) and large artery atherosclerosis (odds ratio 2.1, 95% CI: 1.5-3.8).
Conclusion:
High hsCRP level is strongly associated with and an independent predictor of acute ischemic stroke. The association was found in all ischemic stroke subtypes.
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