##plugins.themes.bootstrap3.article.main##

Stroke is one of the top five leading causes of death in Malaysia and increases in the mortality rate between 2016 and 2019. There is growing evidence that inflammation plays an important role in acute ischemic stroke. Studies showed that the level of inflammatory markers such as C-reactive protein (CRP) and erythrocyte sedimentation rate (ESR) are strongly correlated with the volume of brain infarct detected using Magnetic Resonance Imaging (MRI). This cross-sectional study conducted in Hospital Pengajar Universiti Putra Malaysia (HPUPM) aims to determine the correlation between the volume of MRI brain infarct with inflammatory markers among patients with acute ischemic stroke in HPUPM. Patients’ sociodemographic information and level of inflammatory markers were extracted from the Hospital Information System (eHIS), the MRI images were accessed through the Picture Archiving and Communication System (PACS) whereas the MRI reports for each sample were searched from the Reporting Information System (RIS). In addition, the MRI sequences DWI/ADC and FLAIR axial were selected. The findings of the site and size of brain ischemia were studied. This study was based on 60 data sets of patients diagnosed with acute ischemic stroke in HPUPM. The majority of the patients were male (68.3%), Malay (51.7%) and ranging from age group 61-75 years old. The mean volume of MRI brain infarction was 27.3268±55.6957cm3. A statistically significant association was found between CRP and volume of brain infarction (r=0.297, p<0.05) whereas no association was found between ESR and volume of brain infarction (r=0.192, p>0.05). A significant association was found between CRP and volume of brain infarction. No association was found between ESR and volume of brain infarction.



Downloads

Download data is not yet available.

References

  1. World Health Organization. Global Health Estimates: Deaths by Cause, Age, Sex and Country, 2000–2012. Geneva, WHO, 2014.
     Google Scholar
  2. Loo KW, Gan SH. Burden of stroke in Malaysia. International Journal of Stroke. 2012;7:165–167.
    DOI  |   Google Scholar
  3. Dahshan A, Ebraheim A, Rashed LA and El Ghoneimy AT et al. Evaluation of inflammatory markers and mean platelet volume as short-term outcome indicators in young adults with ischemic stroke. The Egyptian Journal of Neurology, Psychiatry and Neurosurgery. 2019;55-76.
    DOI  |   Google Scholar
  4. Kisialiou A, Pelone G, Carrizzo A, Grillea G, Trimarco V, Marino M, Bartolo M, et al. Blood biomarker’s role in acute ischemic stroke patients: higher is worse or better? Immunity & Ageing, 2012;9(1):1-10.
    DOI  |   Google Scholar
  5. Wong KS, Gao S, Chan YL, et al. Mechanisms of acute cerebral infarctions in patients with middle cerebral artery stenosis: a diffusion-weighted imaging and microemboli monitoring study. Ann Neurol. 2002; 52:74–81.
    DOI  |   Google Scholar
  6. Wyczalkowska-Tomasik A, Czarkowska-Paczek B, Zielenkiewicz M, Paczek L. Inflammatory Markers Change with Age, but do not Fall Beyond Reported Normal Ranges. Archivum immunologiae et therapiae experimentalis. 2016;64(3):249–254. https://doi.org/10.1007/s00005-015-0357-7.
    DOI  |   Google Scholar
  7. Khera A, McGuire DK, Murphy SA, Stanek HG, Das SR, Vongpatanasin W, Wians FH Jr, Grundy SM, de Lemos JA. Race and gender differences in C-reactive protein levels. Journal of the American College of Cardiology. 2005;46(3):464–469. https://doi.org/10.1016/j.jacc.2005.04.051.
    DOI  |   Google Scholar
  8. Nazmi A, Victora CG. Socioeconomic and racial/ethnic differentials of C-reactive protein levels: a systematic review of population-based studies. BMC public health. 2007;7: 212. https://doi.org/10.1186/1471-2458-7-212.
    DOI  |   Google Scholar
  9. Daniels LM, Tosh PK, Fiala JA, Schleck CD, Mandrekar JN, Beckman TJ. Extremely Elevated Erythrocyte Sedimentation Rates: Associations with Patients' Diagnoses, Demographic Characteristics, and Comorbidities. Mayo Clinic proceedings. 2017;92(11):1636–1643. https://doi.org/10.1016/j.mayocp.2017.07.018.
    DOI  |   Google Scholar
  10. Youn CS, Choi SP, Kim SH, Oh SH, Jeong WJ, Kim HJ, Park KN. Serum highly selective C-reactive protein concentration is associated with the volume of ischemic tissue in acute ischemic stroke. The American Journal of Emergency Medicine, 2012;30(1):124–128. https://doi.org/10.1016/j.ajem.2010.11.006.
    DOI  |   Google Scholar
  11. Ormstad H, Aass HCD, Lund-Sørensen N, Amthor K-F, Sandvik L. Serum levels of cytokines and C-reactive protein in acute ischemic stroke patients, and their relationship to stroke lateralization, type, and infarct volume. Journal of Neurology, 2011;258(4):677–685. https://doi.org/10.1007/s00415-011-6006-0.
    DOI  |   Google Scholar
  12. Comoglu S, Cilliler A, Guven, Hayat. Erythrocyte sedimentation rate: Can be a prognostic marker in acute ischemic stroke? Turkish Journal of Cerebrovascular Diseases. 2013;19:18-22. https://doi.org/10.5505/tbdhd.2013.32042.
    DOI  |   Google Scholar
  13. Nayak AR, Kashyap RS, Kabra D, Deoras P, Purohit HJ, Taori GM, Daginawala HF. Evaluation of routinely performed hematological and biochemical parameters for the prognosis of acute ischemic stroke patients. Neurological Sciences, 2011;32(5): 855.
    DOI  |   Google Scholar
  14. Filippi CG, El-Ali AM, Miloushev VZ, Chow DS, Guo X, Zhao B. Computer-assisted volumetric measurement of core infarct volume in pediatric patients: feasibility for clinical use and development of quantitative metrics for outcome prediction. American journal of neuroradiology. 2015;36(4):789–794. https://doi.org/10.3174/ajnr.A4183.
    DOI  |   Google Scholar