scholarly journals C–reactive Protein and Early Mortality in Acute Ischemic Stroke

2012 ◽  
Vol 9 (4) ◽  
pp. 252-255 ◽  
Author(s):  
K R Dewan ◽  
P V S Rana

Background There is growing evidence that inflammation plays an important role in atherogenesis. Several studies have shown that C-reactive protein (CRP), an inflammatory marker, is associated with stroke severity and outcome. But limited studies are there which show the relationship of CRP with early mortality i.e within seven days. Objective To study the association of CRP within 24 hours after acute ischemic stroke onset with severity during admission, types of ischemic stroke and outcome. Methods This cross sectional study was done including 100 consecutive cases of acute ischemic stroke admitted to Neurology center of College of Medical Sciences, Bharatpur (Chitwan), Nepal. The cases were classified as per TOAST classification and severity at admission assessed using National Institutes of Health Stroke Scale. C-reative protein (CRP) level was estimated by latex particle agglutination test. Result Thirteen percent patients expired by 7th day. In the expired group, CRP was positive in 15.3 percent, 15.3 percent and 61.5 percent in patients with lacunar, cardioembolic and large artery atherosclerotic infarction respectively (p 0.19). CRP was positive in all 7 patients (53.8%) who had expired with severe NIHS scale (p 0.004). ConclusionHigh CRP level is associated with stroke severity at admission and is an independent predictor of early seven day mortality after ischemic strokeDOI: http://dx.doi.org/10.3126/kumj.v9i4.6339 Kathmandu Univ Med J 2011;9(4):252-5 

Author(s):  
Betsi Sumanti ◽  
Hexanto Hexanto ◽  
Widiastuti Widiastuti

   ASSOCIATION BETWEEN ALTERED HS-CRP LEVELS AND  COGNITIVE FUNCTION OF ISCHEMIC STROKE PATIENTSABSTRACTIntroduction: The incidence of cognitive impairment in acute ischemic stroke patients is increasing. The mechanism of the inflammatory effect, such as  elevated hs-CRP level, a  non-specific inflammatory marker  sensitive to chronic inflammation due to hypoperfusion as well other vascular risk, is thought to have an effect on cognitive function.Aims: To determine the relationship of cognitive function changes in acute phase of ischemic stroke with hs-CRP level changes on day 3 and day 7 after onset.Methods: This was a cross sectional study of 31 first-timer ischemic stroke patients who met inclusion and exclusion criteria. The level of hs-CRP was checked on the 3rd day and 7th day after onset, while MoCA-Ina was assessed on the 7th day after onset. Cognitive disturbance was considered if MoCA <26. Analyses was done using SPSS 2.0Results: The average onset of day 3 Hs-CRP concentration was 0.66 (0.12-16.67)mg/dl and the onset of day 7 was 5.455 (0.14-17.34)mg/dl. The mean change of hs-CRP level between 3 day and 7 day after onset was -0,16 (-3.32-4.95). There was a significant correlation between elevated hs-CRP levels on day 3 and day 7 after onset with cognitive function of acute ischemic stroke patients.Discussion: There was a significant correlation between elevated hs-CRP levels on day 3 and day 7 after onset with cognitive function of acute ischemic stroke patients.Keyword: Acute ischemic stroke, hs-CRP, MoCA-Ina scoresABSTRAKPendahuluan: Insidens penurunan fungsi kognitif pada pasien stroke iskemik akut semakin meningkat. Hal ini diduga dipengaruhi oleh mekanisme efek inflamasi, meliputi peningkatan kadar high sensitive-C reactive protein (hs-CRP), salah satu penanda inflamasi non-spesifik yang sangat sensitif pada inflamasi kronis, akibat hipoperfusi maupun karena risiko vaskuler lainnya.Tujuan: Mengetahui hubungan perubahan fungsi kognitif pasien stroke iskemik fase akut dengan perubahan kadar hs-CRP hari ke-3 dan hari ke-7 setelah awitan.Metode: Studi potong lintang terhadap penderita stroke iskemik pertama kali yang memenuhi kriteria inklusi dan eksklusi. Dilakukan pemeriksaan kadar hs-CRP hari ke-3 dan hari ke-7 setelah awitan dan MoCA-Ina pada hari ke-7 setelah awitan. Fungsi kognitif dinyatakan terganggu jika MoCA-Ina <26. Analisis data menggunakan program SPSS 22.0.Hasil: Didapatkan rerata kadar Hs-CRP hari ke-3 setelah awitan adalah 0,66 (0,12-16,67)mg/dl dan hari ke-7 setelah awitan adalah 5,455 (0,14-17,34)mg/dl. Dengan rerata perubahan kadar hs-CRP awitan hari ke-3 dan awitan hari ke-7 adalah -0,16 (-3,32-4,95). Didapatkan hubungan yang bermakna antara perubahan kadar hs-CRP hari ke-3 setelah awitan dan hari ke-7 setelah awitan dengan fungsi kognitif pasien stroke iskemik akut.Kesimpulan: Didapatkan hubungan yang bermakna antara peningkatan kadar hs-CRP pada hari ke-7 dan kadar hari ke-3 dengan fungsi kognitif pasien stroke iskemik akut.Kata kunci: hs-CRP, MoCA-Ina, stroke iskemik akut 


2021 ◽  
Vol 28 (03) ◽  
pp. 306-310
Author(s):  
Mahpara Munir ◽  
Hafiz Bilal Bashir ◽  
Madeeha Qamar

Objective: To determine the correlation of mean serum C - reactive protein with frequency of stroke severity in patients with acute ischemic cerebrovascular stroke. Study Design: Descriptive Cross Sectional study. Setting: Department of Medicine, Allied Hospital Punjab Medical College Faisalabad. Period: March 2016 to September 2016 Material & Methods: Patients fulfilling the selection criteria were enrolled in the study. Besides routine laboratory tests, plasma CRP levels on admission were measured in all patients through hospital pathology laboratory. CRP levels were correlated with the results of NIHSS (National institute of health stroke scale) score based assessment of ischemic stroke severity at admission. Results: In our study, out of 50 cases of acute stroke, 62%(n=31) were male and 38%(n=19) were females, mean±sd for age was calculated as 46.82+8.65 years, mean CRP levels was calculated as 8.04+2.15mg/dL, mean NIHSS levels were calculated as 10.08+3. Correlation of mean serum C-reactive protein with frequency of stroke severity in patients with acute ischemic cerebrovascular stroke was calculated where r value was 0.9183 showing a strong positive correlation, which means that high CRP goes with high NIHSS (and vice versa). Conclusion: We concluded that CRP levels are positively correlated with the frequency of stroke severity in patients with acute ischemic cerebrovascular stroke.


Stroke ◽  
2012 ◽  
Vol 43 (suppl_1) ◽  
Author(s):  
Jonathan R Weinstein ◽  
Juliane Schulze ◽  
Richard V Lee ◽  
Dannielle Zierath ◽  
Patricia Tanzi ◽  
...  

Background: Toll-like receptor-4 (TLR4) plays a central role in the pathophysiology of acute ischemic stroke (AIS). Specific single nucleotide polymorphisms (SNPs) in TLR4 including 1063 A/G [Asp299Gly] and 1363 C/T [Thr399Ile] alter immune cell responsiveness to lipopolysaccharide (LPS) and are associated with increased rates of infection. The effect of these TLR4 SNPs on outcome following AIS is unknown. Methods: Patients were prospectively enrolled after onset of AIS. Clinical and demographic data were collected and neurological outcomes assessed at 3 months. Blood was drawn at multiple time points to quantify leukocyte subsets and assess plasma levels of C-reactive protein and a panel of cytokines. Genotyping for the TLR4 SNPs was also performed on blood samples. Uni- and multivariate analyses were performed to assess associations between TLR4 SNP haplotype and (i) each laboratory parameter noted above, (ii) infection risk and (iii) stroke outcome. Results: Of the 42 patients included; 6 (14%) were heterozygous for either one or both TLR4 SNPs. Baseline characteristics were similar in patients with or without a TLR4 SNP. In analyses adjusted for both initial stroke severity and age, the presence of a TLR4 SNP was associated with increases in blood leukocytes, plasma C-reactive protein and the cytokine interleukin-1 receptor antagonist (IL-1ra). The presence of either TLR4 SNP was also associated with a trend toward increased rates of infection (adjusted odds ratio and 95% confidence interval of 8.20 and 0.826-81.5, respectively) and a decreased likelihood of favorable outcome as defined by a modified Rankin Scale score of two or less at three months from stroke onset (0.014, 0.00-0.759). Conclusions: In AIS patients, functionally significant genetic variations in TLR4 influence both rates of stroke-associated infection and neurological outcome. These data suggest a direct connection between TLR4 function and stroke pathophysiology.


Background: Inflammation plays a role in the pathophysiology of cerebral ischemic and also an initial response to brain injury. Inflammation involving Blood and Brain Barrier disturbance, leukocyte infiltration, endothelial cells activation, oxidant and inflammatory mediator buildups which can develop rapidly within hours and can cause secondary injury to brain tissues Objectives: To determine the correlation between Neutrophil-to-Lymphocyte Ratio (NLR) and High Sensitivity C Reactive Protein (hsCRP) with severity and outcome in acute ischemic stroke patients Methods: This study used a cross-sectional design approach. Sampling was done at H. Adam Malik General Hospital Medan and taken as many as 38 subjects. NLR and hsCRP were examined on the first day of admission. Severity was assessed by using the National Institutes of Health Stroke Scale and the outcome was assessed by using the Modified Ranking Scale on the first and fourteenth day of admission. The data analysis used the contingency coefficient correlation test and gamma test. Results: Demographic characteristics of the subjects are; the average age is 62 years old, the highest educational level is high school graduate, and the most occupation is unemployed. There is a positive, moderate, and significant correlation between NLR and severity of acute ischemic stroke (r=0.511; p=0.001). There is a positive, moderate, and significant correlation between NLR and the outcome of acute ischemic stroke (r=0.463; p=0.001). There is a positive, very strong, and significant correlation between hsCRP and severity of acute ischemic stroke (r=0.896; p=0.001). There is a positive, strong, and significant correlation between hsCRP and outcome of acute ischemic stroke (r=0.624; p=0.001) Conclusions: There is a positive and significant correlation between NLR and hsCRP with severity and outcome in acute ischemic stroke patients.


2019 ◽  
Vol 70 (6) ◽  
pp. 2290-2293 ◽  
Author(s):  
Maria Totan ◽  
Elisabeta Antonescu ◽  
Maria Gabriela Catana ◽  
Maria Mihaela Cernusca-Mitariu ◽  
Lavinia Duica ◽  
...  

C-reactive protein (CRP) is a non-specific inflammatory marker, correlated with the severity and prognosis of ischemic stroke. We performed a retrospective study in which were included 81 patients diagnosed with acute ischemic stroke admitted between January and July 2017 in the Department of Neurology, Sibiu Emergency Clinical Hospital. CRP values were classified on three levels (0 - 5 mg / L, 5 - 50 mg / l and] 50 mg / l). We examined the correlation between CRP levels according to the type of ischemic (lacunar / territorial) stroke, the degree of motor deficit (quantified by the mRC scale), the associated risk factors and the mortality rate. PCR values above 50 mg / L were found in patients with territorial stroke (15%). Moderate motor deficits predominate, with PCR values ranging from 5-50 mg / L. The most important risk factors found in the patients included in our study were hypertension and atherosclerosis. We made correlations between these risk factors and the PCR values. In most cases with these two risk factors were recorded a mean PCR value (5-50 mg / L).For atherosclerosis the results were statistically significant, p = 0.021. Most patients (56%) had CRP levels ranging from 5 to 50 mg / L. These values recorded highest death rates. PCR it is an important marker of inflammation and it is important to be determined in all patients with acute ischemic stroke, especially which is thought to be correlated with the prognosis of these patients.


2016 ◽  
Vol 8 (2) ◽  
pp. 109
Author(s):  
Lucia Herminawati ◽  
Andi Wijaya ◽  
Mansyur Arief ◽  
Suryani As'ad

BACKGROUND: Inflammation affects the brain after stroke with main functions to rapidly eliminate the source of the disturbance, remove damaged tissue and then restore tissue homeostasis. High sensitive C-reactive protein (hsCRP) is a sensitive marker of inflammation and tissue injury in the arterial wall, while fractalkine is a distinct chemokine that promotes inflammatory signaling after neuronal death on ischemic stroke. We aim to investigate the association of fractalkine with hsCRP as a marker of inflammation in ischemic stroke patients.METHODS: This study was designed as a cross-sectional study. Soon after patients with ischemic stroke admitted to hospital, plasma fractalkine and hsCRP concentrations were assesed. Subjects had to be at least 30 years old and maximum 30 days of stroke onset. High inflammation was defined as hsCRP value >3 mg/L.RESULTS: High fractalkine levels were found on 24 ischemic stroke patients (49%) and mean of fractalkine 0.719 ng/mL on patients with stroke onset <7 days was higher than patients with stroke onset 7-30 days. Low fractalkine levels (<0.527 ng/mL) were found on ischemic stroke patients with onset 7-30 days accompanied by high inflammation (hsCRP >3 mg/L), but no significant correlation between fractalkine and hsCRP (p=0.613).CONCLUSION: High inflammation and low plasma fractalkine profile was found after 7 days of onset in ischemic stroke patients. No significant correlation between fractalkine and hsCRP in ischemic stroke patients.KEYWORDS: CRP, fractalkine, inflammation, ischemic stroke


Stroke ◽  
2014 ◽  
Vol 45 (suppl_1) ◽  
Author(s):  
Jae Guk Kim ◽  
Youngchai Ko ◽  
Soo Joo Lee

Background and Objectives: Inflammation plays an important role in atherosclerosis and its clinical sequelae. Their relationship to stroke is not settled. We assessed the hypothesis that relative elevations of high-sensitivity C-reactive protein (hs-CRP) and lipoprotein-associated phospholipase A2 (Lp-PLA2) levels at the time of first stroke are associated with stroke severity and prognosis. Methods: First ischemic stroke patients who was admitted within 7days after stroke onset, were prospectively enrolled. High-sensitivity C-reactive protein and Lp-PLA2 level were assayed using the enzyme-linked immunoassay. Vascular risk factors, stroke subtypes, and initial stroke severity were assessed. Stroke severity was evaluated using the National Institutes of Health Stroke Scale (NIHSS) and was categorized as mild (NIHSS score<6), moderate (NIHSS score of 6-13), or severe (NIHSS score≥14). The unfavorable outcome was defined as the modified Rankin Scale of 2-6 at 3month after stroke onset. Results: Two hundred two patients (mean age, 67.5 years; 52.5% male) were included; 104 (51.5%) had unfavorable outcome. Levels of hs-CRP and Lp-PLA2 were weakly correlated (Spearman’s rho=0.174, p=0.01). In univariate analyses, female (p=0.03), patients with large artery atherosclerosis of stroke subtypes (p<0.01), severe NIHSS score (p=0.01), and unfavorable outcome (p<0.01) showed the higher mean value level of hs-CRP level than the others. Patients with hypertension (p=0.03), large artery atherosclerosis (p<0.01), severe NIHSS score (p<0.01), and unfavorable outcome (p=0.01) also had the higher mean value of Lp-PLA2 level than the others. After adjusting for age, sex, vascular risk factors, and initial stroke severity, the high level of hs-CRP was associated with unfavorable outcome (1.71±4.2 vs. 0.26±0.45, odds ratio (OR) 1.82, 95% confidence interval (CI) 1.02-3.27, p=0.04). However, after adjusting for the confounders, Lp-PLA2 was not associated with unfavorable outcome (191.33±77.78 vs. 162.02±61.54, OR 1.00, 95% CI 0.99-1.01, p=0.66). Conclusion: Our findings suggest that the level of hs-CRP and Lp-PLA2 were associated with stroke severity, but only hs-CRP may be useful to predict functional outcome at 3 month after ischemic stroke.


Author(s):  
Raden Muharam ◽  
Muhammad Saiful Rizal

Background: Endometriosis is closely associated with delayed diagnosis due to the lack of a definitive and sensitive noninvasive approach. The use of calprotectin in inflammatory process has been demonstrated in various inflammatory diseases. Calprotectin has a significant correlation with high-sensitivity C-reactive protein (hs- CRP) and could be used as an inflammatory marker. No study thus far has evaluated the correlation between calprotectin and endometriosis. Objective: To determine the correlation of calprotectin with the degree of endometriosis in order to help clinicians in establishing better early detection and management. Materials and Methods: In this cross-sectional study, 46 women referred to the Cipto Mangunkusumo, Fatmawati, and Persahabatan Hospitals in Jakarta, Indonesia between July 2017 and April 2018 were enrolled, and their blood serum were taken a day before surgery. Calprotectin serum level was treated using the Phical® ELISA method. After the diagnosis of endometriosis was confirmed through pathological examination, the final diagnosis of endometriosis could be established. The degree of endometriosis was classified according to the revised American Society for Reproductive Medicine (ASRM) classification. Results: The prevalence of minimal, mild, moderate, and severe degrees of endometriosis were 15.2, 39.1, 34.8, and 10.9%, respectively. The median serum calprotectin levels for minimal, mild, moderate, and severe endometriosis were 138.98, 121.49, 124.16, and 122.82 mg/mL, respectively. No correlation was observed between calprotectin and the degrees of endometriosis (r = –0.16, p = 0.278). Conclusion: There is no correlation between calprotectin serum levels and the degrees of endometriosis. Key words: Calprotectin, Endometriosis, C-reactive protein, Inflammation.


Sign in / Sign up

Export Citation Format

Share Document