N-terminal pro-B-type natriuretic peptide, high-sensitivity C-reactive protein and ferritin in predicting the functional outcome in stroke patients

Abstract

Abstract Background: Biomarkers that predict the outcome of stroke are critical for treatment, considering them to be a valuable adjunct to routine clinical examination and imaging data. Methods: Thirty-one patients admitted with stroke along with 30 controls were included in the study. Patients were divided into ischaemic and haemorrhagic stroke groups based on radiological findings. The study group was evaluated within 48 h of symptom onset for clinical stroke severity (Scandinavian Stroke Scale [SSS] and National Institute of Health Stroke Scale). Functional status before the stroke (modified Rankin Scale [mRS]) and at discharge was evaluated. The association of N-terminal pro-B-type natriuretic peptide (NT-proBNP), high-sensitivity C-reactive protein (hsCRP) and serum ferritin concentrations with stroke severity and functional outcomes at discharge in acute ischaemic and haemorrhagic stroke patients. Results: The median NT-proBNP, hsCRP and ferritin serum concentrations were significantly high for cases when compared to controls (P < 0.05). However, serum concentrations of NT-proBNP, hsCRP and ferritin were not significantly different when ischaemic and haemorrhagic stroke patients were compared. HsCRP showed a negative correlation with SSS score on admission and showed a positive correlation with mRS at discharge. In multivariate adjusted regression models, hsCRP remained associated with worse functional outcomes at discharge. Conclusions: In acute stroke patients, elevated concentration of hsCRP is associated with greater clinical stroke severity and worse functional outcomes at discharge. Hence, it can be used along with computed tomography scan/magnetic resonance imaging for assessment of stroke severity.