Serum hsCRP: A Novel Marker for Prediction of Cerebrovascular Accidents (Stroke)

Abstract

Introduction and Objectives: Strokes are caused by disruption of the blood supply to the brain. This may result from either blockage or rupture of a blood vessel. Yearly 15 million people worldwide suffer a stroke. India ranks second worldwide in terms of deaths from stroke. The incidence of stroke increases with age affecting the economically productive middle aged population. Hypertension and male sex are other risk factors for stroke. C-Reactive Protein (CRP) is an acute phase protein whose concentration rises in blood following inflammation. Formerly, assays for CRP detected its rise only after significant inflammation. However, recently developed high sensitivity assays (hsCRP) enable the measurement of CRP in individuals who are apparently healthy. Several studies indicate that hsCRP is elevated in individuals who are at risk of developing Coronary Artery Disease or Cerebrovascular events, the elevation may be found years before the first detection of vascular problems. In the absence of other biochemical markers, the present study aimed to evaluate the predictive and diagnostic role of hsCRP in stroke. Materials and Methods: The study consisted of 50 patients of acute stroke admitted in Gauhati Medical College and Hospital. The control population consisted of two groups – 50 age and sex matched controls with hypertension (Hypertensive control group) and 50 age and sex matched controls with no obvious disease constituted the Normal control group. hsCRP levels were measured in all the groups and compared statistically. Results: The mean age of stroke patients was 58 y. The highest frequency of stroke incidence was in the 51–60 y age group. The rise in hsCRP in stroke patients (40.8±11.06 mg/L) was found to be significant in comparison to that in hypertensives (8.181±2.539 mg/L) and in normal controls (1.143±0.725 mg/L). Conclusion: hsCRP is an acute phase reactant whose concentration rises in stroke as well as in those at risk. The rise may be identified even before the appearance of risk factors. Hence, hsCRP may be useful as a predictive and diagnostic marker in stroke.

Keywords

• high-sensitivity c-reactive protein
• haemorrhagic stroke
• ischemic stroke