Predictive ability of C-reactive protein for stroke

Stroke is an important cause of morbidity and mortality as well as functional impairment particularly in the elderly people (1). Prediction of stroke outcome in high risk patients by appropriate marker and application of preventive measures may delay or prevent development of irreversible brain damage and subsequent functional impairment (2). Development of stroke is the result of longstanding vascular inflammation, plaque rupture, thrombosis and subsequent brain ischemia or infarction (3). Among the several markers of inflammation, serum C-reactive protein (CRP) is of particular importance. This marker can be used not only for the detection of inflammatory state and evaluation of treatment (4, 5) but also for the prediction of future development of atherosclerotic diseases including stroke and cardiovascular disease (6). Bakhsayesh et al. in one issue of Caspian Journal of Internal Medicine have investigated the ability of serum CRP and white blood cell (WBC) as markers of inflammation in predicting the outcome of acute ischemic stroke. The results indicated that serum CRP levels >10.5 m/l predicted mortality of stroke over three months of follow-up duration at sensitivity and specificity of 75% and 63.8%, respectively. In addition, serum CRP > 8.5mg/l differentiated stroke patients with and without poor prognosis at sensitivity of 73.1%, and specificity of 69.4% whereas WBC showed predictive ability for stroke (7).