A Study of High Sensitivity C - reactive Protein in Cerebrovascular Accident

Background: Inflammation plays an important role in the pathogenesis of stroke. C-reactive protein (CRP) is the most reliable marker of inflammation. Cerebrovascular accident is the second most common cause of death in the world causing about 5 million deaths in a year. High sensitivity CRP (hsCRP) refers to lower detection limits of assay procedure being used (1 mg/L). High levels of hsCRP in stroke indicates poor prognosis.

Objectives: The objectives of the study are to observe the levels of hsCRP in cerebrovascular accident, the role of hsCRP in differentiating ischemic and hemorrhagic stroke, the relation between the levels of hsCRP and the size of the lesion and the outcome of patients with stroke in relation to hsCRP.

Methodology: Fifty patients with first episode of stroke as evidenced by CT scan, presenting to the Department of General Medicine, SVRRGG Hospital, Tirupati from August 2013 to August 2014 are studied and the levels of hsCRP are measured and analyzed.

Results: In the study, majority of the patients (58%) are in the age group of 56-70 years with a male preponderance. Hypertension (62%) is the commonest risk factor observed followed by smoking (40%) and diabetes (36%). Most of the study population (96%) has raised hsCRP levels. Mean hsCRP (in mg/L) is high in patients with large (>3 cm) infarcts (53.51±18.13) compared to those with small (<3 cm) infarcts (8.71±6.27). In hemorrhagic stroke, mean hsCRP is high in patients with large (32.11±28.11) bleeds than those with small bleeds (12.90±11.14). In both ischemic and hemorrhagic stroke non survivors have hsCRP levels higher than survivors and the levels correlate with GCS score.

Conclusion: hsCRP is raised in both ischemic and hemorrhagic stroke. The rise in hsCRP is less in small lesions compared to that of large lesions and the levels are high in diseased than in survivor group.