Document Type : Special Articles

Authors

• Jaydip Ray Chaudhuri ¹
• Kandadai Rukmini Mridula ²
• Matapathi Umamahesh ³
• Alluri Swathi ⁴
• Banda Balaraju ⁵
• Venkata Chandrasekher Srinivasarao Bandaru ⁶

¹ Department of Neurology,Yashoda Hospital, Hyderabad, India.

² Assistant Professor, Department of Neurology, Nizams’s Institute of Medical Sciences, Hyderabad, India

³ Department of Radiology, Yashoda Hospital, Hyderabad, India

⁴ Clinical Register, Department of Neurology, Yashoda Hospital, Hyderabad, India

⁵ Department of Medicine, Yashoda Hospital, Hyderabad, India

⁶ Research Coordinator, Department of Neurology and Clinical Research, Yashoda Hospital, Hyderabad, India

Abstract

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.