Humanities
Skip to main content Skip to main navigation menu Skip to site footer
  • Register
  • Login
  • Menu
  • Home
  • Current
  • Archives
  • Announcements
  • About
    • About the Journal
    • Submissions
    • Editorial Team
    • Privacy Statement
    • Contact
  • Register
  • Login

Journal of Education, Health and Sport

C-Reactive protein as a biomarker affecting neurorehabilitation outcomes in post-stroke patients: state of knowledge and global trends in research
  • Home
  • /
  • C-Reactive protein as a biomarker affecting neurorehabilitation outcomes in post-stroke patients: state of knowledge and global trends in research
  1. Home /
  2. Archives /
  3. Vol. 13 No. 4 (2023) /
  4. Articles

C-Reactive protein as a biomarker affecting neurorehabilitation outcomes in post-stroke patients: state of knowledge and global trends in research

Authors

  • Wojciech Borowicz Department of Pediatric Infectious Diseases, Wroclaw Medical University, Wroclaw, Poland https://orcid.org/0000-0002-6119-297X
  • Marta Szczepańska Centre of Neurorehabilitation AFA-MED, Żary, Poland https://orcid.org/0000-0003-4996-2318
  • Joanna Rosińczuk Department of Nursing and Obstetrics, Wroclaw Medical University, Wroclaw, Poland https://orcid.org/0000-0003-0168-1701

DOI:

https://doi.org/10.12775/JEHS.2023.13.04.010

Keywords

ischemic stroke, C-reactive protein, biomarkers, neurorehabilitation, functional abilities, knowledge, critical care

Abstract

Background: C-reactive protein (CRP) is a commonly determined biomarker of inflammation and may reflect the progression of a vascular disease. CRP values within 12 to 24 hours of stroke symptom onset are an independent predictor of adverse functional outcome in terms of the level of motor recovery in the first year of follow-up. Objective: This study aims to provide a complementary analysis of the scientific literature and critically review studies on the use of CRP as a potential biomarker associated with stroke and affecting the achievement of neurorehabilitation progress in post-stroke patients. Methods: This critical review of the literature was prepared based on the following inclusion criteria: (1) original research, (2) studies indexed in PubMed, Scopus and PEDro databases, (3) full-text articles in English, (4) papers published in 2012 – 2022, and (5) papers addressing the use of PCR assay as a biomarker of rehabilitation effectiveness. Results: Based on a review of PubMed, Scopus and PEDro databases, 47, 56 and 9 papers, respectively, were selected based on precisely selected keywords and included in full for further full text review. In this review, the most important scientific rationale was included in response to the aim of this paper. Summary: Recognition of the role of inflammatory and immunological factors in the development of atherosclerosis and the occurrence of ischaemic stroke provides scope for the search for new methods of stroke risk assessment and the development of new methods to prevent stroke. Further empirical validation and unequivocal demonstration of the levels of CRP as a potential marker that affects the health status of a post-stroke patient are needed to ensure the greatest possible level of motor recovery and ability to function independently in terms of all activities of daily living.

References

Donkor ES. Stroke in the 21st Century: A Snapshot of the Burden, Epidemiology, and Quality of Life. Stroke Res Treat. 2018;2018. doi:10.1155/2018/3238165

Kuriakose D, Xiao Z. Pathophysiology and Treatment of Stroke: Present Status and Future Perspectives. Int J Mol Sci. 2020;21(20):7609. doi:10.3390/ijms21207609

Platz T. Evidence-Based Guidelines and Clinical Pathways in Stroke Rehabilitation-An International Perspective. Front Neurol. 2019;10:200. doi:10.3389/fneur.2019.00200

Pilato F, Calandrelli R, Capone F, et al. New Perspectives in Stroke Management: Old Issues and New Pathways. Brain Sci. 2021;11(6):767. doi:10.3390/brainsci11060767

McCoy CE, Langdorf MI, Lotfipour S. American Heart Association/American Stroke Association Deletes Sections from 2018 Stroke Guidelines. West J Emerg Med. 2018;19(6):947-951. doi:10.5811/westjem.2018.9.39659

Kim J, Thayabaranathan T, Donnan GA, et al. Global Stroke Statistics 2019. Int J Stroke Off J Int Stroke Soc. 2020;15(8):819-838. doi:10.1177/1747493020909545

Zhu H. A Large-Scale Prospective Study on Functional Ability and Mortality Following Stroke Based on HRS Data Set: Implications for Rehabilitation. Front Psychol. 2022;13:915653. doi:10.3389/fpsyg.2022.915653

Shrivastava SR, Shrivastava PS, Ramasamy JD. Reduction in global burden of stroke in underserved areas. J Neurosci Rural Pract. 2013;4(4):475-476. doi:10.4103/0976-3147.120194

Heuschmann PU, Wiedmann S, Wellwood I, et al. Three-month stroke outcome: the European Registers of Stroke (EROS) investigators. Neurology. 2011;76(2):159-165. doi:10.1212/WNL.0b013e318206ca1e

Norrving B, Barrick J, Davalos A, et al. Action Plan for Stroke in Europe 2018–2030. Eur Stroke J. 2018;3(4):309-336. doi:10.1177/2396987318808719

Koton S, Sang Y, Schneider ALC, Rosamond WD, Gottesman RF, Coresh J. Trends in Stroke Incidence Rates in Older US Adults: An Update From the Atherosclerosis Risk in Communities (ARIC) Cohort Study. JAMA Neurol. 2020;77(1):109-113. doi:10.1001/jamaneurol.2019.3258

Lui SK, Nguyen MH. Elderly Stroke Rehabilitation: Overcoming the Complications and Its Associated Challenges. Curr Gerontol Geriatr Res. 2018;2018:9853837. doi:10.1155/2018/9853837

Lee KB, Lim SH, Kim KH, et al. Six-month functional recovery of stroke patients: a multi-time-point study. Int J Rehabil Res. 2015;38(2):173-180. doi:10.1097/MRR.0000000000000108

van Mierlo ML, van Heugten CM, Post MWM, Hajós TRS, Kappelle LJ, Visser-Meily JMA. Quality of Life during the First Two Years Post Stroke: The Restore4Stroke Cohort Study. Cerebrovasc Dis Basel Switz. 2016;41(1-2):19-26. doi:10.1159/000441197

Hartley T, Burger M, Inglis-Jassiem G. Post stroke health-related quality of life, stroke severity and function: A longitudinal cohort study. Afr J Disabil. 2022;11:947. doi:10.4102/ajod.v11i0.947

Biomarkers Definitions Working Group. Biomarkers and surrogate endpoints: preferred definitions and conceptual framework. Clin Pharmacol Ther. 2001;69(3):89-95. doi:10.1067/mcp.2001.113989

Al-hadlaq SM, Balto HA, Hassan WM, Marraiki NA, El-Ansary AK. Biomarkers of non-communicable chronic disease: an update on contemporary methods. PeerJ. 2022;10. doi:10.7717/peerj.12977

Califf RM. Biomarker definitions and their applications. Exp Biol Med Maywood NJ. 2018;243(3):213-221. doi:10.1177/1535370217750088

Jayaraj RL, Azimullah S, Beiram R, Jalal FY, Rosenberg GA. Neuroinflammation: friend and foe for ischemic stroke. J Neuroinflammation. 2019;16(1):142. doi:10.1186/s12974-019-1516-2

Sheriff A, Kayser S, Brunner P, Vogt B. C-Reactive Protein Triggers Cell Death in Ischemic Cells. Front Immunol. 2021;12:630430. doi:10.3389/fimmu.2021.630430

Swastini DA, Wiryanthini IAD, Ariastuti NLP, Muliantara A. Atherosclerosis Prediction with High Sensitivity C-Reactive Protein (hs-CRP) and Related Risk Factor in Patient with Dyslipidemia. Open Access Maced J Med Sci. 2019;7(22):3887-3890. doi:10.3889/oamjms.2019.526

Zhang X, Wang S, Fang S, Yu B. Prognostic Role of High Sensitivity C-Reactive Protein in Patients With Acute Myocardial Infarction. Front Cardiovasc Med. 2021;8:659446. doi:10.3389/fcvm.2021.659446

Winbeck K, Poppert H, Etgen T, Conrad B, Sander D. Prognostic relevance of early serial C-reactive protein measurements after first ischemic stroke. Stroke. 2002;33(10):2459-2464. doi:10.1161/01.str.0000029828.51413.82

Song IU, Kim YD, Kim JS, Lee KS, Chung SW. Can high-sensitivity C-reactive protein and plasma homocysteine levels independently predict the prognosis of patients with functional disability after first-ever ischemic stroke? Eur Neurol. 2010;64(5):304-310. doi:10.1159/000321415

Chei CL, Yamagishi K, Kitamura A, et al. C-reactive protein levels and risk of stroke and its subtype in Japanese: The Circulatory Risk in Communities Study (CIRCS). Atherosclerosis. 2011;217(1):187-193. doi:10.1016/j.atherosclerosis.2011.03.001

Sproston NR, Ashworth JJ. Role of C-Reactive Protein at Sites of Inflammation and Infection. Front Immunol. 2018;9:754. doi:10.3389/fimmu.2018.00754

Baethge C, Goldbeck-Wood S, Mertens S. SANRA-a scale for the quality assessment of narrative review articles. Res Integr Peer Rev. 2019;4:5. doi:10.1186/s41073-019-0064-8

Brown D. A Review of the PubMed PICO Tool: Using Evidence-Based Practice in Health Education. Health Promot Pract. 2020;21(4):496-498. doi:10.1177/1524839919893361

Narrative Review Checklist. Elsevier; 2022. https://www.elsevier.com/__data/promis_misc/ANDJ%20Narrative%20Review%20Checklist.pdf

Kim S, Yeganova L, Wilbur WJ. Meshable: searching PubMed abstracts by utilizing MeSH and MeSH-derived topical terms. Bioinformatics. 2016;32(19):3044-3046. doi:10.1093/bioinformatics/btw331

Mengozzi M, Kirkham FA, Girdwood EER, et al. C-Reactive Protein Predicts Further Ischemic Events in Patients With Transient Ischemic Attack or Lacunar Stroke. Front Immunol. 2020;11:1403. doi:10.3389/fimmu.2020.01403

Nafari A, Mohammadifard N, Haghighatdoost F, et al. High-sensitivity C-reactive protein and low-density lipoprotein cholesterol association with incident of cardiovascular events: Isfahan cohort study. BMC Cardiovasc Disord. 2022;22(1):241. doi:10.1186/s12872-022-02663-0

Wnuk M, Derbisz J, Drabik L, Slowik A. C-Reactive Protein and White Blood Cell Count in Non-Infective Acute Ischemic Stroke Patients Treated with Intravenous Thrombolysis. J Clin Med. 2021;10(8):1610. doi:10.3390/jcm10081610

Geng HH, Wang XW, Fu RL, et al. The Relationship between C-Reactive Protein Level and Discharge Outcome in Patients with Acute Ischemic Stroke. Int J Environ Res Public Health. 2016;13(7):636. doi:10.3390/ijerph13070636

Tu WJ, Zhao SJ, Liu TG, Yang DG, Chen H. Combination of high-sensitivity C-reactive protein and homocysteine predicts the short-term outcomes of Chinese patients with acute ischemic stroke. Neurol Res. 2013;35(9):912-921. doi:10.1179/1743132813Y.0000000228

Nozoe M, Kanai M, Kubo H, et al. Changes in Quadriceps Muscle Thickness, Disease Severity, Nutritional Status, and C-Reactive Protein after Acute Stroke. J Stroke Cerebrovasc Dis Off J Natl Stroke Assoc. 2016;25(10):2470-2474. doi:10.1016/j.jstrokecerebrovasdis.2016.06.020

Karlinski M, Bembenek J, Grabska K, et al. Routine serum C-reactive protein and stroke outcome after intravenous thrombolysis. Acta Neurol Scand. 2014;130(5):305-311. doi:10.1111/ane.12227

Jiménez MC, Rexrode KM, Glynn RJ, Ridker PM, Gaziano JM, Sesso HD. Association Between High-Sensitivity C-Reactive Protein and Total Stroke by Hypertensive Status Among Men. J Am Heart Assoc. 2015;4(9):e002073. doi:10.1161/JAHA.115.002073

Wu Q, Cui J, Xie Y, et al. Outcomes of Ischemic Stroke and Associated Factors Among Elderly Patients With Large-Artery Atherosclerosis: A Hospital-Based Follow-Up Study in China. Front Neurol. 2021;12:642426. doi:10.3389/fneur.2021.642426

Matsuo R, Ago T, Hata J, et al. Plasma C-Reactive Protein and Clinical Outcomes after Acute Ischemic Stroke: A Prospective Observational Study. PloS One. 2016;11(6):e0156790. doi:10.1371/journal.pone.0156790

Peña Sánchez M, González García S, González-Quevedo Monteagudo A, et al. Increased C-reactive protein in acute ischemic stroke patients is age dependent. Rev Cuba Investig Bioméd. 2020;39(3). Accessed December 10, 2022. http://scielo.sld.cu/scielo.php?script=sci_abstract&pid=S0864-03002020000300006&lng=es&nrm=iso&tlng=en

Peng Y, Dong B, Wang Z. Overall and Gender-specific Associations between C-reactive Protein and Stroke Occurrence: A Cross-sectional Study in US. J Stroke. 2016;18(3):355-357. doi:10.5853/jos.2016.00451

Rost NS, Wolf PA, Kase CS, et al. Plasma concentration of C-reactive protein and risk of ischemic stroke and transient ischemic attack: the Framingham study. Stroke. 2001;32(11):2575-2579. doi:10.1161/hs1101.098151

Liu Y, Wang J, Zhang L, et al. Relationship between C - Reactive Protein and Stroke: A Large Prospective Community Based Study. PLoS ONE. 2014;9(9):e107017. doi:10.1371/journal.pone.0107017

Rajeshwar K, Kaul S, Al-Hazzani A, et al. C-reactive protein and nitric oxide levels in ischemic stroke and its subtypes: correlation with clinical outcome. Inflammation. 2012;35(3):978-984. doi:10.1007/s10753-011-9401-x

Van Gilder RL, Davidov DM, Stinehart KR, et al. C-reactive protein and long-term ischemic stroke prognosis. J Clin Neurosci. 2014;21(4):547-553. doi:10.1016/j.jocn.2013.06.015

Ye Z, Zhang Z, Zhang H, et al. Prognostic Value of C-Reactive Protein and Homocysteine in Large-Artery Atherosclerotic Stroke: a Prospective Observational Study. J Stroke Cerebrovasc Dis. 2017;26(3):618-626. doi:10.1016/j.jstrokecerebrovasdis.2016.11.016

Ahmadi Ahangar A, Saadat P, Taheri Otaghsara ST, Alijanpour S. C-Reactive Protein Level in Admission and the Outcome of Stroke Survivors. J Babol Univ Med Sci. 2020;22(1):210-214. doi:10.22088/jbums.22.1.210

Totan M, Antonescu E, Catana MG, et al. C-Reactive Protein - A Predictable Biomarker in Ischemic Stroke. Rev Chim. 2019;70(6):2290-2293.

Gu HQ, Yang KX, Lin JX, et al. Association between high-sensitivity C-reactive protein, functional disability, and stroke recurrence in patients with acute ischaemic stroke: A mediation analysis. EBioMedicine. 2022;80:104054. doi:10.1016/j.ebiom.2022.104054

Taheraghdam A, Aminnejad S, Pashapour A, Rikhtegar R, Ghabili K. Is there a correlation between hs-CRP levels and functional outcome of Ischemic Stroke? Pak J Med Sci. 2013;29(1):166-169. doi:10.12669/pjms.291.2799

Ozkan AK, Yemisci OU, Saracgil Cosar SN, Oztop P, Turhan N. Can high-sensitivity C-reactive protein and ferritin predict functional outcome in acute ischemic stroke? A prospective study. Top Stroke Rehabil. 2013;20(6):528-536. doi:10.1310/tsr2006-528

Åberg ND, Wall A, Anger O, et al. Circulating levels of vascular endothelial growth factor and post-stroke long-term functional outcome. Acta Neurol Scand. 2020;141(5):405-414. doi:10.1111/ane.13219

Zhang YY, Huang NN, Zhao YX, et al. Elevated Tumor Necrosis Factor-a-induced Protein 8-like 2 mRNA from Peripheral Blood Mononuclear Cells in Patients with Acute Ischemic Stroke. Int J Med Sci. 2018;15(14):1713-1722. doi:10.7150/ijms.27817

Cheng LS, Tu WJ, Shen Y, Zhang LJ, Ji K. Combination of High-Sensitivity C-Reactive Protein and Homocysteine Predicts the Post-Stroke Depression in Patients with Ischemic Stroke. Mol Neurobiol. 2018;55(4):2952-2958. doi:10.1007/s12035-017-0549-8

Downloads

  • PDF

Published

2023-02-16

How to Cite

1.
BOROWICZ, Wojciech, SZCZEPAŃSKA, Marta and ROSIŃCZUK, Joanna. C-Reactive protein as a biomarker affecting neurorehabilitation outcomes in post-stroke patients: state of knowledge and global trends in research. Journal of Education, Health and Sport. Online. 16 February 2023. Vol. 13, no. 4, pp. 92-107. [Accessed 23 May 2025]. DOI 10.12775/JEHS.2023.13.04.010.
  • ISO 690
  • ACM
  • ACS
  • APA
  • ABNT
  • Chicago
  • Harvard
  • IEEE
  • MLA
  • Turabian
  • Vancouver
Download Citation
  • Endnote/Zotero/Mendeley (RIS)
  • BibTeX

Issue

Vol. 13 No. 4 (2023)

Section

Articles

License

Copyright (c) 2023 Wojciech Borowicz, Marta Szczepańska, Joanna Rosińczuk

Creative Commons License

This work is licensed under a Creative Commons Attribution-NonCommercial-ShareAlike 4.0 International License.

The periodical offers access to content in the Open Access system under the Creative Commons Attribution-NonCommercial-ShareAlike 4.0

Stats

Number of views and downloads: 830
Number of citations: 0

Search

Search

Browse

  • Browse Author Index
  • Issue archive

User

User

Current Issue

  • Atom logo
  • RSS2 logo
  • RSS1 logo

Information

  • For Readers
  • For Authors
  • For Librarians

Newsletter

Subscribe Unsubscribe

Tags

Search using one of provided tags:

ischemic stroke, C-reactive protein, biomarkers, neurorehabilitation, functional abilities, knowledge, critical care
Up

Akademicka Platforma Czasopism

Najlepsze czasopisma naukowe i akademickie w jednym miejscu

apcz.umk.pl

Partners

  • Akademia Ignatianum w Krakowie
  • Akademickie Towarzystwo Andragogiczne
  • Fundacja Copernicus na rzecz Rozwoju Badań Naukowych
  • Instytut Historii im. Tadeusza Manteuffla Polskiej Akademii Nauk
  • Instytut Kultur Śródziemnomorskich i Orientalnych PAN
  • Instytut Tomistyczny
  • Karmelitański Instytut Duchowości w Krakowie
  • Ministerstwo Kultury i Dziedzictwa Narodowego
  • Państwowa Akademia Nauk Stosowanych w Krośnie
  • Państwowa Akademia Nauk Stosowanych we Włocławku
  • Państwowa Wyższa Szkoła Zawodowa im. Stanisława Pigonia w Krośnie
  • Polska Fundacja Przemysłu Kosmicznego
  • Polskie Towarzystwo Ekonomiczne
  • Polskie Towarzystwo Ludoznawcze
  • Towarzystwo Miłośników Torunia
  • Towarzystwo Naukowe w Toruniu
  • Uniwersytet im. Adama Mickiewicza w Poznaniu
  • Uniwersytet Komisji Edukacji Narodowej w Krakowie
  • Uniwersytet Mikołaja Kopernika
  • Uniwersytet w Białymstoku
  • Uniwersytet Warszawski
  • Wojewódzka Biblioteka Publiczna - Książnica Kopernikańska
  • Wyższe Seminarium Duchowne w Pelplinie / Wydawnictwo Diecezjalne „Bernardinum" w Pelplinie

© 2021- Nicolaus Copernicus University Accessibility statement Shop