The aim of this study was to evaluate the role of C-reactive protein (CRP), alongside other inflammation markers, in predicting ischemic stroke outcome.

Ischemic stroke is the leading cause of death and disability worldwide. A link between stroke and inflammation has long been reported. The immune system is known to influence both the acute phase and chronic repair process of cerebrovascular events through cytokine production and cell-mediated response.

Starting from 1058 subjects, we enrolled in the final analysis 341 ischemic stroke patients. We divided them according to their mRS score at the 3-month follow-up outpatient visit: 217 patients had an mRS score between 0-2 (good outcome), whereas 124 had mRS score of 3-6 (poor outcome). We found that high CRP, ESR and the systemic inflammation response index (SIRI) were significantly associated with poor outcomes. Among these, CRP levels appeared to be independent predictors of poor outcomes.
We dichotomized the population into deceased and alive at 3 months (25 vs. 316 patients), finding that elevated values of CRP, ESR and SIRI were statistically associated with higher mortality, while CRP was the only parameter to be an independent predictor. Moreover, through a ROC curve analysis, we identified a cut-off value of 21.9 mg/L for CRP to predict mortality with good sensitivity-specificity (76/78%)