Chan Ka Lung, Feng Xueyan, Ip Bonaventure, Huang Shangmeng, Ma Sze Ho, Fan Florence S Y, Ip Hing Lung, Huang Li'an, Mok Vincent C T, Soo Yannie O Y, Leung Thomas W, Leng Xinyi
Department of Medicine and Therapeutics, The Chinese University of Hong Kong, Hong Kong, China.
Department of Neurology, The First Affiliated Hospital, Jinan University, Guangzhou, China.
Front Aging Neurosci. 2021 Apr 20;13:646961. doi: 10.3389/fnagi.2021.646961. eCollection 2021.
The risk of recurrent stroke following a minor stroke or transient ischemic attack (TIA) is high, when inflammation might play an important role. We aimed to evaluate the value of neutrophil to lymphocyte ratio (NLR) in predicting composite cardiovascular events in patients with minor stroke and TIA.
Consecutive patients with acute minor stroke or TIA admitted within 24 h of symptoms onset during a 5-year period in a prospective stroke registry were analyzed. We calculated the NLR dividing absolute neutrophil count by absolute lymphocyte count tested within 24 h of admission. NLR ≥4th quartile was defined as high NLR. A composite outcome was defined as stroke, acute coronary syndrome or vascular death within 1 year. We investigated associations between NLR and the composite outcome in univariate and multivariate analyses, among all patients and in those aged over 60 years (i.e., older patients).
Overall, 841 patients (median age 68 years; 60.4% males) were recruited. No significant independent association was found between NLR and the composite outcome in multivariate analysis in the overall cohort. Among the 612 older patients (median age 73 years; 59.2% males), the median NLR was 2.76 (interquartile range 1.96-4.00) and 148 (24.2%) patients had high NLR. The composite outcome occurred in 77 (12.6%) older patients, who were more likely to have a high NLR (39.0% versus 22.1%; = 0.001) than those without a composite outcome. In multivariate logistic regression, high NLR (adjusted odds ratio 2.00; 95% confidence interval 1.07-3.75; = 0.031) was independently associated with the composite outcome in older patients.
In older (aged ≥60 years) patients with acute minor stroke or TIA, a higher NLR, a marker of systemic inflammation that can be easily obtained in routine blood tests, is an independent predictor of subsequent cardiovascular events.
轻度卒中或短暂性脑缺血发作（TIA）后复发性卒中的风险很高，炎症可能在其中起重要作用。我们旨在评估中性粒细胞与淋巴细胞比值（NLR）在预测轻度卒中和TIA患者复合心血管事件中的价值。
对前瞻性卒中登记处5年内症状发作后24小时内收治的连续性急性轻度卒中和TIA患者进行分析。我们通过入院24小时内检测的绝对中性粒细胞计数除以绝对淋巴细胞计数来计算NLR。NLR≥第4四分位数被定义为高NLR。复合结局定义为1年内发生卒中、急性冠状动脉综合征或血管性死亡。我们在单因素和多因素分析中研究了NLR与复合结局之间的关联，包括所有患者以及60岁以上（即老年患者）的患者。
总体而言，共纳入841例患者（中位年龄68岁；男性占60.4%）。在整个队列的多因素分析中，未发现NLR与复合结局之间存在显著的独立关联。在612例老年患者（中位年龄73岁；男性占59.2%）中，NLR的中位数为2.76（四分位间距1.96 - 4.00），148例（24.2%）患者NLR较高。77例（12.6%）老年患者出现了复合结局，与未出现复合结局的患者相比，他们更有可能具有较高的NLR（39.0%对22.1%；P = 0.001）。在多因素逻辑回归分析中，高NLR（调整后的优势比为2.00；95%置信区间为1.07 - 3.75；P = 0.031）与老年患者的复合结局独立相关。
在急性轻度卒中和TIA的老年（≥60岁）患者中，较高的NLR是随后心血管事件的独立预测指标，NLR是一种全身炎症标志物，可在常规血液检查中轻松获得。
