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July2014 Vol.51 Issue:        3       (Supp.) Table of Contents
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C-Reactive Protein: A Potential Biomarker for Differentiating Ischemic from Hemorrhagic Stroke

Mohamed A. Shoaeb1, Mohamed A. Shehata2, Khaled M. Taema2, Mohamed A. Hammouda2

Department of Critical Care Medicine, Damietta General Hospital1, Cairo University2; Egypt


Background: The early diagnosis of ischemic stroke is a key element in decision making for the use of fibrinolytic therapy. The use of a biomarker for the pre-hospital differentiation between ischemic and hemorrhagic strokes appears promising. Objective: We intended in this study to evaluate the role of measuring serum CRP for the differentiation between ischemic and hemorrhagic strokes. Methods: We included 50 patients with first-ever acute stroke admitted within the 1st 24 hours of onset. According to admission CT results, our patients were classified into ischemic and hemorrhagic stroke groups, each group included 25 patients. Stroke severity was assessed by National Institute of Health Stroke Scale (NIHSS). Seven days later, we evaluated the outcome using modified Rankin Scale (mRS) and Barthel ADL index (BI). CRP was measured for all patients on admission. Results: Our population age was 59.5±8.6 years old. Both groups were comparable in baseline demographic and clinical data. NIHSS was positively correlated with mRS and negatively correlated with BI. There was no significant difference between both groups in terms of disease severity or outcome. CRP was significantly higher in ischemic stroke than in hemorrhagic stroke. CRP was 9±5.5 mg/L in ischemic stroke compared to 6.2±3.8 mg/L in hemorrhagic stroke (P=0.039). CRP level of 5.8 mg/L was found to identify ischemic stroke with sensitivity and specificity of only 64% and 60%. Conclusion: We concluded that despite that serum CRP could differentiate ischemic from hemorrhagic stroke, it cannot be used for decision making in context of fibrinolytic therapy use. [Egypt J Neurol Psychiat Neurosurg.  2014; 51(3): 311-320]

Key words: CRP, Biomarkers, Ischemic stroke.

Correspondence to Khaled M. Taema, Critical Care Medicine Department, Cairo University, Egypt. Tel.: +201000412603    Email:

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