Evaluation of Prognostic Role of Serum CRP in Acute Stroke Patients

Cerebrovascular disease includes all disorders in which an area of the brain is transiently or permanently affected by ischemia or bleeding and one or more of the cerebral blood vessels are involved in the pathological process. C-reactive protein (CRP) is one of the first acute phase proteins that increases during systemic inflammation and is also the one that exhibits the most dramatic increase in concentration. The serum CRP is a significant measure that appears to be connected with the neurological outcome of patients who have suffered an acute stroke. This study evaluated the prognostic role of Serum CRP in acute stroke patients. The comparative prospective study was carried out in the department of Biochemistry BSMMU, total N=50 diagnosed acute stroke patients were enrolled in this study. Stroke patients were diagnosed by CT scan or MRI. The age range of the study subjects was 33-80 years. Serum CRP was measured in all the study subjects, post stroke neurological outcome was assessed by mRS (Modified Rankin Scale), four weeks after an acute stroke. Good outcome was considered as mRS <4 (Group-A) & poor outcome mRS >3 (Group-B). Statistical analyses were performed by using SPSS for windows version 12.0. Unpaired ‘t’ test, Mann Whitney U test, Chi-square test and Spearman’s rho correlation test were used to see the level of significance 95% confidence limit (p <0.05) was taken as level of significance. With respect to CRP level the median serum CRP concentration in acute patients was median was 3.7mg/l (range 3–45 mg/l), which was much higher than upper reference range (<1 mg/l). A significant high level of serum CRP was found in poor outcome group as compared to good outcome group. There was a significant association of poor neurological outcome with high serum CRP level (X² value = 38.57, p <.001). Correlation analysis of serum CRP level with mRS score showed a strong positive correlation, which indicate that mRS score increase with increase in serum CRP level. The study concluded that serum CRP concentration increased in stroke patients as well as Serum CRP concentration positively correlated with post stroke neurological outcome as assessed by mRS score. Serum CRP level may be estimated in all stroke patients as prognostic tool to predict post stroke neurological outcome.