Correlation between High-Sensitivity C-Reactive Protein Levels with Cognitive Function and Clinical Outcome in Acute Ischemic Stroke Patients

Abstract

Introduction: Inflammation plays a critical role in the pathophysiology of ischemic stroke. High-sensitivity C-reactive protein (hs-CRP) is a biomarker of systemic inflammation that may reflect neuronal injury and predict neurological outcomes. However, the relationship between hs-CRP levels, cognitive impairment, and functional outcomes in acute ischemic stroke remains unclear.

Objectives: To evaluate the correlation between serum hs-CRP levels, cognitive function, and clinical outcomes in patients with acute ischemic stroke.

Methods: This observational cross-sectional study was conducted at Dr. Wahidin Sudirohusodo Hospital and affiliated hospitals in Makassar between December 2025 and February 2026. Sixty-four patients with acute ischemic stroke (onset 1–7 days) were recruited using consecutive sampling. Serum hs-CRP levels were measured using enzyme‑linked immunosorbent assay (ELISA). Cognitive function was assessed using the Montreal Cognitive Assessment Indonesian version (MoCA-INA), and functional outcomes were evaluated using the modified Rankin Scale (mRS). Correlation analysis between hs-CRP levels and clinical parameters was performed using Spearman correlation.

Results: The mean age of participants was 57.91 ± 9.41 years, and 54.7% were male. The median hs-CRP level was 166.99 pg/mL, and the median mRS score was 2 (range 1–5 Spearman correlation analysis demonstrated a strong negative correlation between hs-CRP levels and MoCA-INA scores (r = −0.638; p < 0.001). However, no significant correlation was observed between hs-CRP levels and mRS scores (p = 0.817).

Conclusions: Elevated hs-CRP levels were significantly associated with poorer cognitive function in patients with acute ischemic stroke but were not associated with functional outcomes measured by the modified Rankin Scale.