The correlation between C-Reactive Protein, Vascular Cell Adhesion Molecule-1, and S100b with Alberta stroke program early CT Score in non-hemorrhagic stroke patients

Abstract

Background: Stroke is the leading cause of disability and the second-most cause of death in Indonesia, caused by atherosclerotic obstructions in the cerebral and cervical arteries. C-reactive protein (CRP) is an acute-phase protein synthesized after the stimulation of the pro-inflammatory cytokines. Vascular cell adhesion molecule 1 (VCAM-1) is a sign of both inflammation and atherosclerosis. S100B protein is the dominant protein in the central nervous system released in the event of inflammation in the brain, such as stroke. CT-scan is a gold-standard diagnosis of non-hemorrhagic stroke. However, it has a limit to the onset of <6 hours. The Alberta stroke program early CT-score (ASPECTS) system enhances non-contrast CT-scan sensitivity in assessing early ischemic changes in areas supplied by the middle cerebral artery (MCA). The correlation between inflammatory variables and ischemic assessments on CT-scan needs to be analyzed further. This study aimed to prove the correlation between acute inflammatory signs and ischemic assessment using ASPECTS in non-hemorrhagic stroke patients.Methods: This study was a cross-sectional study conducted in April-September 2019 on 47 non-hemorrhagic stroke patients in Diponegoro National Hospital, Telogorejo Hospital, and Tugurejo Hospital, Semarang. The diagnosis of non-hemorrhagic stroke was based on the non-contrast CT-scan and subsequent ASPECTS assessment. CRP, VCAM-1, and S100B levels were examined using the ELISA principle. The correlation test between variables was also performed employing the Spearman test.Results: The correlation test results between the CRP, VCAM-1, and S100B levels with the ASPECTS were r = -0.035, p = 0.815; r = -0.117, p = 0,432; and r = 0.145, p = 0.332, respectively.Conclusions: There was no significant correlation between the CRP, VCAM-1, and S100B levels with the ASPECTS. The increase in CRP and S100B inflammatory signs was not accompanied by low ASPECTS assessment, which depended on the appearance of lesions on the CT-scan.