Prognostic significance of inflammatory biomarkers (CRP, IL-6, procalcitonin) in patients with ischemic stroke in intensive care settings

Background. Inflammatory biomarkers play a critical role in the early diagnosis, prognosis, and clinical management of patients with ischemic stroke, particularly in intensive care settings. Purpose – conduct a systematic summary and meta-analysis of existing clinical studies in order to assess the prognostic value of inflammatory biomarkers – C-reactive protein (CRP), interleukin-6 (IL-6), and procalcitonin (PCT) – in patients with ischemic stroke who were hospitalized in intensive care units, taking into account their impact on clinical outcomes, severity of condition, risk of complications, and mortality. Materials and methods. A systematic literature review was conducted, analyzing 40 peer-reviewed studies that met predefined inclusion criteria. The primary focus was on evaluating the temporal dynamics, diagnostic utility, and prognostic relevance of CRP, IL-6, and PCT in patients with acute ischemic stroke. Results. CRP was identified as a sensitive marker of systemic inflammation, with plasma levels rising within 6–12 hours post-stroke and peaking at 24–48 hours. Levels exceeding 10 mg/L were associated with larger infarct size, increased risk of aspiration pneumonia, and poor functional outcomes. IL-6, a key cytokine in the acute-phase response, was found to correlate with infarct volume, blood–brain barrier disruption, and the risk of early neurological deterioration. Elevated IL-6 (>20 pg/mL) indicated severe systemic immune activation and predicted complications such as pneumonia and sepsis. PCT, a specific marker of bacterial infection, was useful in distinguishing post-stroke systemic inflammation from infectious processes. A PCT level >0.25 ng/mL within 48 hours post-admission signaled a high risk of bacterial complications, enabling timely antimicrobial intervention. Conclusion. CRP, IL-6, and PCT have significant diagnostic and prognostic utility in the intensive care management of ischemic stroke. Regular monitoring of these biomarkers enhances risk stratification, guides therapeutic decision-making, and facilitates early identification of infectious and inflammatory complications, ultimately improving patient outcomes.