ORIGINAL: Assessing the Correlation of Protein C and Protein S Levels with Stroke Severity and Functional Outcomes in Adults with Ischaemic Stroke
West Afr J Med. July 2025; 42(7): 523-530 PMID: 41370113
Keywords:
Barthel Index, Ischemic Stroke, Modified Rankin Score, Protein C, Protein S, ThrombophiliaAbstract
Background: Protein C, a vitamin K-dependent anticoagulant, regulates thrombin generation with its cofactor, protein S. Deficiencies in these proteins predispose individuals to thrombophilia, which may contribute to ischemic stroke. However, data on their role in Nigerian populations remain limited.
Objectives: To compare serum levels of protein C and protein S between adults with acute ischemic stroke and matched healthy controls; to assess associations between these deficiencies and stroke severity; and to evaluate their relationship with functional outcomes.
Methods: A hospital-based, cross-sectional case-control study was conducted involving 100 ischemic stroke patients and 100 age- and sex-matched healthy controls. Serum protein C and S levels were measured using enzyme-linked immunosorbent assay (ELISA). Stroke severity was assessed using the National Institutes of Health Stroke Scale (NIHSS), while functional outcomes were measured using the Barthel Index and Modified Rankin Scale (mRS) on days 7, 14, and 30. Statistical analysis was performed using SPSS version 25, with significance set at p < 0.05.
Results: Among 200 participants (59 males, 41 females per group), the mean age of stroke patients was 61.24 ± 13.30 years. Median time to presentation was 48 hours. Protein C levels were significantly lower in stroke patients, while Protein S showed no significant difference. A weak positive correlation was observed between Protein C levels and stroke severity (rs = 0.201, p = 0.045), whereas Protein S did not show such a correlation. The functional outcome showed no significant association with either protein.
Conclusion: Protein C deficiency may serve as a marker for stroke severity but has limited predictive value for functional outcomes. Further research is needed to clarify its pathophysiological role in ischemic stroke.
