Serum C-Reactive Protein Level as a Biomarker for Differentiation of Ischemic from Hemorrhagic Stroke
,
Abstract
Cerebrovascular accidents rank first in the frequency and importance among all neurological disease. Although a number of studies had shown increased level of the high sensitive C-reactive protein (hsCRP) in patients with ischemic stroke, the association of increased hs-CRP with various type of stroke especially the assessment hs-CRP level in ischemic and hemorrhagic stroke have not been investigated. In the present study, we assessed the concentration of hs-CRP in patients with documented ischemic and hemorrhagic stroke in the first 24 hours of the onset of symptoms. Thirty-two patients with Ischemic and hemorrhagic stroke were evaluated at neurology department of Poursina Hospital. The presence of baseline vascular risk factors, including hypertension, diabetes mellitus, hypercholesterolemia, obesity, and smoking, was determined. The blood samples were then collected and routine hematology and biochemistry tests were done. hs-CRP levels were determined using a highly sensitive immunonephelometric method. In this cross sectional study, the age of patient varied from 45–85 years (Mean 70.9 9.4). Serum level of hs-CRP in Ischemic patients were 18.92 11.28 and in hemorrhagic group was 2.65 1.7. This relationship was statistically significant (P<0.0001). It might be concluded that hs-CRP might be considered as a usefully adjunct method for the initial diagnosis of the type of stroke.
Sweileh WM, Sawalha AF, Al-Aqad SM, Zyoud SH, Al- Jabi SW. The epidemiology of stroke in northern palestine: a 1-year, hospital-based study. J Stroke Cerebrovasc Dis 2008;17(6):406-11.
Ridker PM, Silvertown JD. Inflammation, C-reactive protein, and atherothrombosis. J Periodontol 2008;79(8 Suppl):1544-51.
Eikelboom JW, Hankey GJ, Baker RI, McQuillan A, Thom J, Staton J, Cole V, Yi Q. C-reactive protein in ischemic stroke and its etiologic subtypes. J Stroke Cerebrovasc Dis 2003;12(2):74-81.
Wakugawa Y, Kiyohara Y, Tanizaki Y, Kubo M, Ninomiya T, Hata J, Doi Y, Okubo K, Oishi Y, Shikata K, Yonemoto K, Maebuchi D, Ibayashi S, Iida M. C-reactive protein and risk of first-ever ischemic and hemorrhagic stroke in a general Japanese population: the Hisayama Study. Stroke 2006;37(1):27-32. Epub 2005 Nov23.
Curb JD, Abbott RD, Rodriguez BL, Sakkinen P, Popper JS, Yano K, Tracy RP. C-reactive protein and the future risk of thromboembolic stroke in healthy men. Circulation 2003;107(15):2016-20. Epub 2003 Apr 7.
Kaplan RC, McGinn AP, Baird AE, Hendrix SL, Kooperberg C, Lynch J, Rosenbaum DM, Johnson KC, Strickler HD, Wassertheil-Smoller S. Inflammation and hemostasis biomarkers for predicting stroke in postmenopausal women: the Women's Health Initiative Observational Study. J Stroke Cerebrovasc Dis 2008;17(6):344-55.
Mendall MA, Patel P, Ballam L, Strachan D, Northfield TC. C reactive protein and its relation to cardiovascular risk factors: a population based cross sectional study. BMJ 1996;312(7038):1061-5.
Pinto A, Tuttolomondo A, Di Raimondo D, Fernandez P, Licata G. Cerebrovascular risk factors and clinical classification of strokes. Semin Vasc Med 2004;4(3):287-303.
Bahadursingh S, Beharry K, Maharaj K, Mootoo C, Sharma P, Singh J, Teelucksingh K, Tilluckdharry R. Creactive protein: adjunct to cardiovascular risk assessment. West Indian Med J 2009;58(6):551-5.
Ridker PM, Buring JE, Shih J, Matias M, Hennekens CH. Prospective study of C-reactive protein and the risk of future cardiovascular events among apparently healthy women. Circulation 1998;98(8):731-3.
Ridker PM, Hennekens CH, Buring JE, Rifai N. C-reactive protein and other markers of inflammation in the prediction of cardiovascular disease in women. N Engl J Med 2000;342(12):836-43.
Price DT, Loscalzo J. Cellular adhesion molecules and atherogenesis. Am J Med 1999;107(1):85-97.
Umemura T, Kawamura T, Sakakibara T, Kanai A, Sano T, Hotta N, Sobue G. Association of soluble adhesion molecule and C-reactive protein levels with silent brain infarction in patients with and without type 2 diabetes. Curr Neurovasc Res 2008;5(2):106-11.
Blankenberg S, Barbaux S, Tiret L. Adhesion molecules and atherosclerosis. Atherosclerosis. 2003;170(2):191-203.
Yin WH, Chen JW, Young MS, Lin SJ. Increased endothelial monocyte adhesiveness is related to clinical outcomes in chronic heart failure. Int J Cardiol 2007;121(3):276-83. Epub 2006 Dec 22.
Kanai A, Kawamura T, Umemura T, Nagashima M, Nakamura N, Nakayama M, Sano T, Nakashima E, Hamada Y, Nakamura J, Hotta N. Association between future events of brain infarction and soluble levels of intercellular adhesion molecule-1 and C-reactive protein in patients with type 2 diabetes mellitus. Diabetes Res Clin Pract 2008;82(2):157-64. Epub 2008 Aug 9.
Tanne D, Haim M, Boyko V, Goldbourt U, Reshef T, Matetzky S, Adler Y, Mekori YA, Behar S. Soluble intercellular adhesion molecule-1 and risk of future ischemic stroke: a nested case-control study from the Bezafibrate Infarction Prevention (BIP) study cohort. Stroke 2002;33(9):2182-6.
Terruzzi A, Valente L, Mariani R, Moschini L, Camerlingo M. C-reactive protein and aetiological subtypes of cerebral infarction. Neurol Sci 2008;29(4):245-9. Epub 2008 Sep20.
Di Napoli M, Papa F, Bocola V. C-reactive protein in ischemic stroke: an independent prognostic factor. Stroke 2001;32(4):917-24.
Zhou WJ, Zhu DL, Yang GY, Zhang Y, Wang HY, Ji KD, Lu YM, Gao PJ. Circulating endothelial progenitor cells in Chinese patients with acute stroke. Hypertens Res 2009;32(4):306-10. Epub 2009 Feb 27.
Varoglu AO, Kuyucu M, Demir R, Acemoglu H, Can I, Akcay F. Prognostic values of lesion volume and biochemical markers in ischemic and hemorrhagic stroke: a stereological and clinical study. Int J Neurosci 2009;119(12):2206-18.
| Files | ||
| Issue | Vol 49, No 3 (2011) | |
| Section | Articles | |
| Keywords | ||
| Cerebrovascuar accidents High sensitive C-reactive protein (hs-CRP) Ischemic stroke Hemorrhagic stroke | ||
| Rights and permissions | |
|
This work is licensed under a Creative Commons Attribution-NonCommercial 4.0 International License. |
