IJCRR - 5(2), January, 2013
STUDY OF PROGNOSTIC SIGNIFICANCE OF SERUM C-REACTIVE PROTEIN AND ESR IN ACUTE ISCHEMIC STROKE
Author: Krishna Murthy H.A., Renuka Prasad Y.S.
Background of the study: The stroke is defined as rapidly developing clinical signs of focal or global disturbance of cerebral function, lasting more than 24 hrs or leading to death, with no apparent cause other than vascular origin.1,2 An increasing body of evidence has linked inflammation with the pathogenesis of atherothrombotic stroke. The serum C-reactive protein (CRP) and ESR are acute-phase reactants, are indicators of underlying inflammation of endothelium and novel plasma markers for atherothrombotic disease.3,4,5
Aims and objectives: 1. To study the serum concentration of C-Reactive Protein [CRP] and ESR in patients of Acute ischemic stroke. 2. To compare it with that of age and sex matched controls. 3. One month follow up of the cases to know the results of stroke.
Methods: It is a case control study, in this 50 cases, who has CT brain confirmed, first attack of Acute ischemic stroke and 50 healthy controls were taken. For all patients CRP and ESR levels were measured, with in 72 hours of onset of stroke and followed up for one month to know the results of cases.
Results: The mean serum CRP level among the cases was 4.5±2.58mg/L and that among the controls it was 0.88±0.41 mg/L with the p value of < 0.001. There were 88% (44) of cases and 24% (12) of controls has CRP levels >0.8mg/L and 12%(6) of cases and 76%(38) of controls has CRP levels <0.8mg/L. The mean ESR value among the cases and controls in the present study was 32.33+11.80mm/hr and 19.80±6.80mm/hr respectively. After one month of follow up 12%(6) of cases with serum CRP value of 5.4mg/L and ESR of 38mm/hr were died, 26%(13) of patients with serum CRP value of 3.2mg/L and ESR of 25mm/hr were recovered from neurological features and 62%(31) of patients with serum CRP value of 4.9mg/L and ESR value of 34mm/hr were remained with same neurological features, which was statistically significant with the p value of <0.05, deaths were seen in highly raised CRP and ESR cases.
Conclusion:The serum CRP and ESR levels were higher in the cases compared to controls and the statistically significant results were also seen with the follow up of the cases.Hence it can be concluded that,inflammation is an important risk factor of endothelial damage and atherosclerosis.So measures to reduce the inflammation of endothelium and atherosclerotic plaque of blood vessels, in the long run can significantly reduce the incidence of stroke and its consequences in predisposed individuals.
Keywords: Acute ischemic stroke, CRP, ESR.
Krishna Murthy H.A., Renuka Prasad Y.S.. STUDY OF PROGNOSTIC SIGNIFICANCE OF SERUM C-REACTIVE PROTEIN AND ESR IN ACUTE ISCHEMIC STROKE International Journal of Current Research and Review. 5(2), January, 127-134
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List of abbreviations used; CRP-Creactiveprotein; ESR-Erythrocyte sedimentation rate.