The Relationship of CRP/Albumin Ratio with Etiology and Prognosis in Acute Ischemic Stroke

INTRODUCTION: Inflammation has a role in both the onset and progression of atherosclerosis. C-reactive protein (CRP) and albumin are indicators of inflammation and related to atherosclerosis and stroke. The ratio of CRP to albumin (CAR) is thought to have prognostic significance in systemic inflammation. However, the relationship between CAR and acute ischemic stroke (AIS) is yet to be clarified. METHODS: Between January 2016 and January 2018, 477 patients who were hospitalized in the Neurology Department with a diagnosis of AIS and 189 control cases were examined. Stroke severity of patients who admitted in first 24 h were evaluated with the National Institute of Health Stroke Scale (NIHSS) score. The relationship between CAR and stroke severity, early prognosis, and etiologic subtypes was evaluated. RESULTS: The mean age of patients was 69.54+-12.8. While 52.2% of patients were male, 47.8% were female. The mean CAR values were 66.79+-9.02 in the patient group and 36.19+-3.56 in the control group. There was significant difference between the two groups (p<0.0001). With regard to NIHSS scores, there was significant difference between the mild (score <8), moderate (score 8–14), and severe (score >14) groups in terms of CAR values (60.7+-8.5; 87.7+-9.53; and 89.04+-12.02) (p=0.0019). The mean CAR values in the atherothrombotic and cardioembolic groups were 94.553+-9.36 and 60.974+-9.36, respectively, and there was significant difference between the two groups (p=0.004). In terms of early prognosis, the mean CAR value of good prognosis (mRS: 0–2) and poor prognosis (mRS: 3–6) patients was 60.72+-8.86 and 85.16+-9.33, respectively. There was a strong statistical relationship between the CAR values and early prognosis (p<0.001). No statistically significant relationship was found according to either age or gender. DISCUSSION AND CONCLUSION: The strong relationship between high CAR values and stroke severity, bad early prognosis, and atherothrombotic stroke raises the question of whether or not the CAR value can be used as a predictive marker for the prognosis and etiologic subtype of stroke.