Study of inflammatory markers after acute ischemic stroke: A cross-sectional study

Abstract

Background: Stroke remains a leading cause of mortality and long-term disability worldwide, with ischemic stroke accounting for the majority of cases. Increasing evidence suggests that inflammation plays a pivotal role in the pathogenesis and prognosis of acute ischemic stroke. Inflammatory biomarkers such as C-reactive protein (CRP), leukocyte count and erythrocyte sedimentation rate (ESR) have been linked to both the severity and outcome of ischemic injury. Objective: To assess the levels of inflammatory markers (CRP, leukocyte count, and ESR) in patients with acute ischemic stroke and to determine their association with stroke subtype and clinical outcome. Methods: This cross-sectional study was conducted at the Department of Medicine, Shaheed Suhrawardi Medical College & Hospital, Dhaka, over six months (December 2010–May 2011). Fifty patients aged 18 years and above with confirmed acute ischemic stroke (by CT and/or MRI within seven days of onset) were enrolled. Patients with hemorrhagic stroke or any known infective/inflammatory condition were excluded. Data on demographic, behavioral, and clinical characteristics were collected. Serum CRP, leukocyte count, and ESR were measured to evaluate the inflammatory response. Data were analyzed using SPSS version 11.5, applying descriptive statistics, Chi-square tests, ANOVA, and unpaired t-tests where appropriate, with p< 0.05 considered statistically significant. Results: The mean age of the patients was 65.6 ± 10.7 years; 68% were male and 48% were smokers. Hypertension (92%) and diabetes (46%) were the most common comorbidities. Mean CRP and leukocyte counts were significantly higher in patients who died compared to survivors (CRP: 9.8 ± 2.1 vs. 8.7 ± 1.3 mg/L, p = 0.045; leukocyte count: 18.0 ± 0.1×10⁹ vs. 11.4 ± 3.4×10⁹/μL, p = 0.011). ESR was slightly lower among non-survivors (20.0 ± 0.2 vs. 24.5 ± 2.5 mm/hr, p = 0.009). Patients with cerebral infarction had significantly higher leukocyte counts compared to those with cerebellar or lacunar infarction (p = 0.039). Conclusion: Elevated inflammatory markers, particularly CRP and leukocyte count, are associated with poor outcomes in acute ischemic stroke, highlighting their potential prognostic significance in early disease evaluation and management.