title: High sensitivity C-reactive protein levels in Acute Ischemic Stroke and subtypes: A study from a tertiary care center.
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).
  
  
  CONCLUSIONS
  High hsCRP level is strongly associated with and an independent predictor of acute ischemic stroke. The association was found in all ischemic stroke subtypes.
authors.affiliation: Department of Neurology, Yashoda Hospital, Hyderabad, India.
authors.forename: Jaydip Ray
authors.initials: JR
authors.lastname: Chaudhuri
authors.forename: Kandadai Rukmini
authors.initials: KR
authors.lastname: Mridula
authors.forename: Matapathi
authors.initials: M
authors.lastname: Umamahesh
authors.forename: Alluri
authors.initials: A
authors.lastname: Swathi
authors.forename: Banda
authors.initials: B
authors.lastname: Balaraju
authors.forename: Venkata Chandrasekher Srinivasarao
authors.initials: VC
authors.lastname: Bandaru
keywords: HsCRP; Indian Patients; Ischemic Stroke; Stroke Subtypes